改善遵守基于证据的实验室测试建议和监测相关患者结果
AORN journal
|July 29, 2024
概括
一家医院修订了手术前实验室检测协议,以减少不必要的测试. 虽然没有达到20%的减少目标,但不必要的测试减少了,患者的治疗结果没有受到影响.
科学领域:
- 医疗保健管理的管理
- 临床实验室科学 临床实验室科学
- 患者安全 患者安全
背景情况:
- 术前实验室检测协议往往包括不必要的测试.
- 基于证据的指导方针建议减少常规的手术前实验室订单.
- 不必要的测试增加了医疗保健成本,并可能导致患者焦虑.
研究的目的:
- 根据证据和指导方针,修订一个手术前实验室测试协议.
- 将不必要的实验室测试减少20%,而不会影响患者的治疗结果.
- 评估实施的策略在减少测试订单方面的有效性.
主要方法:
- 修订了手术前实验室检测协议.
- 将修订后的协议纳入电子健康记录.
- 实施补充策略:教育网络研讨会和外科医生绩效表.
- 审计实验室测试订单和手术并发症率.
主要成果:
- 最初的目标是将不必要的测试减少20%,但未能实现.
- 观察到对低风险患者订购不必要的实验室测试的下降趋势.
- 在项目期间,手术并发症和实验室检测之间没有发现联系.
- 临床医生继续使用修订后的协议.
结论:
- 实施基于证据的协议可以减少不必要的手术前实验室测试.
- 包括教育和绩效跟踪在内的多方面的策略可能是必要的,以实现显著的减少.
- 在修改检测协议时,确保患者安全和避免负面结果至关重要.
- 持续遵守修订后的协议是可以在学术医学环境中实现的.
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