管理受物质障碍影响的母婴双:全州范围的质量合作倡议.
Kimberly Spence1, Alison Williams2
1Associate Professor of Pediatrics, Division of Neonatal-perinatal Medicine, Saint Louis University School of Medicine and Chair of SSM Cardinal Glennon Ethics Team, SLUcare-SSM Health, St. Louis.
一个质量改进项目为受物质滥用障碍 (SUD) 影响的母亲和婴儿提供了标准化的护理. 这一举措改善了查,减少了婴儿转移,并加强了母婴二合一的出院计划.
科学领域:
- 围产期健康 围产期健康
- 药物滥用 疾病 药物滥用 疾病
- 提高医疗保健的质量 改善医疗保健的质量
背景情况:
- 新生儿戒断综合征 (NAS) /新生儿阿片类药物戒断综合征 (NOWS) 和物质滥用障碍 (SUD) 显著影响母亲和婴儿的结果.
- 有效的护理需要一个双向的方法,同时治疗母亲和婴儿.
- 标准化护理协议对于改善这一群体的治疗结果至关重要.
研究的目的:
- 实施和评估一项全州范围的质量改善 (QI) 项目,旨在标准化对受SUD影响的母婴双胞胎的护理.
- 评估远程医疗支持的协作对暴露在物质中的新生儿及其母亲的护理服务的影响.
- 促进跨部门的合作,以改善围产期SUD护理.
主要方法:
- 密苏里州医院协会 (MHA) 与远程医疗项目Show-Me ECHO合作,启动了一项全州范围的QI项目.
- 从2021年1月到2022年12月,14家医院参与了该项目,使用ECHO模型和技术支持.
- 关键绩效指标包括非药物政策实施,孕产妇SUD查率,婴儿转移率和安全护理退院计划.
主要成果:
- 100%的参与分娩中心对暴露在物质中的新生儿实施了非药物政策.
- 母亲SUD查显著增加了67.3% (从57.5%增加到96.2%).
- 婴儿转移率下降了24%,而安全护理出院计划增加了婴儿的37%,母亲的144%.
结论:
- 这项合作展示了全州范围的,跨部门的QI倡议的可行性和有效性,用于受SUD影响的母婴双.
- 通过远程医疗的支持,标准化,双层护理显著改善了关键的质量指标.
- 该模型提供了一种可扩展的方法,以增强产周SUD护理,并改善母婴结果.
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