改善对静脉血栓栓塞症患者未分离的氨酸输注的护士驱动协议的遵守
Katy M Toale1, Gina Butler, Goley Richardson
1Katy M. Toale is a clinical pharmacy specialist at the University of Texas MD Anderson Cancer Center in Houston, where Gina Butler and Goley Richardson are associate directors of nursing programs, Jeff Beno is a senior health care systems engineer, and Neetha Jawe is a senior clinical quality improvement consultant. The authors acknowledge Dawn Chalaire, associate director for editing services, Research Medical Library, University of Texas MD Anderson Cancer Center, for her editorial assistance. Contact author: Katy M. Toale, khanzelka@mdanderson.org. The authors have disclosed no potential conflicts of interest, financial or otherwise.
改善对静脉血栓塞栓症 (VTE) 治疗的未分离肝素 (UFH) 协议的遵守,减少了安全事件. 这项质量改进倡议通过优化UFH输液管理和减少治疗抗凝剂的时间来增强患者护理.
科学领域:
- 改善医疗质量 改善医疗质量
- 药理学 药理学是指药理学的学科.
- 患者安全 患者安全
背景情况:
- 未分离的肝素 (UFH) 是一种高风险的抗凝剂,有可能导致出血和血栓性并发症.
- 与静脉血栓栓塞 (VTE) 的UFH输注相关的患者安全事件的发生率很高.
- 由于UFH输注的管理不足,需要优化协议.
研究的目的:
- 通过改善护士驱动的VTE治疗UFH输液协议的遵守来提高患者的安全.
- 通过提高质量来减少与UFH治疗相关的不良事件.
主要方法:
- 基线数据收集确定了VTE UFH协议的改进领域.
- 测量了符合八个关键的护理标准.
- 评估了第一次治疗激活的部分血栓形成时间 (aPTT) 的时间.
主要成果:
- 对UFH协议的总体遵守率从79.4%增加到85.2%.
- 达到治疗性aPTT的中位时间从831.5分钟减少到808分钟.
- 多学科干预包括政策更新,电子健康记录优化和护理教育.
结论:
- 一个多学科的质量改进计划成功提高了对护士驱动的UFH协议的遵守.
- 改善的协议坚持与治疗抗凝固药的时间缩短相关.
- 优化UFH管理协议对于VTE治疗的安全性和有效性至关重要.
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