协同安全:通过NICU的共享决策来限制计划外输的定制方法
Parvathy Krishnan1, Nilima Jawale1,2, Adam Sodikoff1
1From the Department of Neonatal-Perinatal Medicine, Westchester Medical Center, and New York Medical College, Valhalla, N.Y.
Pediatric quality & safety
|May 16, 2024
概括
在医疗保健专业人员之间实施共享决策,大大降低了新生儿重症监护病房的非计划性输出管 (UE) 率. 这种协作方法使UE减少了48%,提高了患者的安全性.
科学领域:
- 新生儿重症监护室 (NICU) 的患者安全.
- 改善医疗保健的质量
- 跨学科的医疗保健合作.
背景情况:
- 无计划的输出管 (UE) 是新生儿重症监护室 (NICU) 中一个关键的患者安全问题.
- 一项质量改善倡议旨在通过加强合作和共享决策,将UE率降低10%.
研究的目的:
- 降低新生儿重症监护室 (NICU) 意外输出管 (UE) 的发生率.
- 强调护士,呼吸治疗师和医生之间的合作.
- 实施患者护理的共享决策模式.
主要方法:
- 建立了一个跨学科的质量改进团队 (护士,呼吸治疗师,医生).
- 标准化了UE的定义,并使用明显原因分析进行审计.
- 代实施干预措施,每月审查一次,并采用共享决策.
主要成果:
- 基线UE率为每100个通风器日中的2.3.
- 重用,床边护理和重新定位是UE的主要原因.
- 到2022年12月,实现了48%的欧盟税率降低,到2023年3月为特殊原因变化.
结论:
- 关于减少再利用的孤立教育不足以降低UE率.
- 涉及所有医疗保健专业人员的共同决策显著减少了UE.
- 系统的风险因素评估和协作实践是提高NICU安全性的关键.
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