编码红色:产后出血捆绑干预质量改进项目
Stefanie Modri1, Mehar Sharma, Elizabeth Quigley
1Author Affiliations: Family and Community Health Department (Mrs. Modri), University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania Pre-Health Post-Baccalaureate Program (Ms Sharma), University of Pennsylvania, Philadelphia, Pennsylvania Nursing Department (Mrs. Quigley), Labor and Delivery Unit (Mrs. Anca and Mrs. O'Hanlon), Mother-Baby Unit (Miss. Pyle and Mrs. Hussey), Women's Services Department (Dr. Hamm), Pennsylvania Hospital, Philadelphia, Pennsylvania University of Michigan Medical School (Ms Mohika), Ann Arbor, Michigan, Nursing Department (Dr Trout), Villanova University M. Louise Fitzpatrick College of Nursing, Villanova, Pennsylvania.
红色代码项目成功地减少了用于产后出血 (PPH) 管理的血液制品的使用. 这种标准化干预包显著降低了PPH治疗中血液产品的利用率.
科学领域:
- 产科和妇科 产科和妇科
- 孕产妇健康 孕产妇健康
- 提高医疗保健的质量 改善医疗保健的质量
背景情况:
- 产后出血 (PPH) 是美国孕产妇死亡的主要原因.
- 在费城的三级医院发现了严重的孕产妇发病率和死亡率的健康差异,PPH是主要的贡献者.
- 红色代码项目是为了通过改善PPH管理来解决这些差异而启动的.
研究的目的:
- 实施和评估一个标准化干预捆绑用于管理产后出血 (PPH).
- 通过加强管理协议,减少与PPH相关的发病率和死亡率.
- 通过针对PPH来解决严重的孕产妇结果中现有的健康差异.
主要方法:
- 一种使用计划-做-研究-行动 (PDSA) 周期的质量改进方法.
- 用中断时间序列分析来评估干预的影响.
- 实施Code Crimson包,包括标准化血液产品的管理和大规模的输血协议的激活.
主要成果:
- 对于PPH治疗的整体血液产品利用的显著减少 (P < .001).
- 超过4个单位的包装红细胞的管理下降.
- 在患有PPH的患者中观察到平均血液损失的轻微减少.
结论:
- 红色法典标准化捆绑有效地减少了血液产品在治疗产后出血的利用.
- 这项干预表明了成功的方法来缓解与PPH相关的并发症.
- 该项目强调了标准化协议在改善孕产妇的结果和解决健康差异方面的潜力.
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