通过标准化和实时决策支持,减少早产婴儿的输出失败
Igor Khodak1, Michael Kahovec1, Vince Romano1
1Department of Pediatrics, University of Rochester, Rochester, New York.
Pediatrics
|August 9, 2024
概括
实施标准化方法和电子病历 (EMR) 计算器显著减少了早产新生儿失败的输出管. 这项质量改善计划改善了呼吸支和减少了机械通风的持续时间.
科学领域:
- 新生儿医学 新生儿医学
- 提高质量 提高科学 提高质量
- 临床信息学 临床信息学
背景情况:
- 在早产新生儿中,失败的输出管导致肺部发病率增加.
- 标准化输出管后护理和利用决策支持工具对于改善结果至关重要.
研究的目的:
- 通过使用质量改进方法,将早产婴儿 (<32周妊娠年龄或<1500克) 的失败排卵减少50%.
- 将实时输出管成功计算器集成到电子病历 (EMR).
主要方法:
- 利用计划-做-研究-行动 (PDSA) 周期来实现实践标准化.
- 开发并实施了一个基于EMR的计算器,用于排泄准备.
- 通过使用统计过程控制图表,跟踪输出管失败率,呼吸机日和早期再输入管.
主要成果:
- 从10.3%降低到2.3%的输出失败率.
- 机械通风平均日数从10.8日减少到7.0日.
- 观察到早些时候 (<3天) 出管的婴儿从60.2%增加到73.6%.
结论:
- 实践标准化和EMR集成的决策支持工具有效地提高了输出管成功率.
- 实施的策略导致更早的输出管,并减少了早产婴儿机械通风的持续时间.
- 这项质量改进倡议证明了成功的模型,可以减少脆弱新生儿的不良呼吸系统结果.
相关概念视频
Endotracheal Tube Extubation
516
Endotracheal tube extubation is a critical procedure in weaning patients from mechanical ventilation. It involves physically removing the oral or nasal endotracheal (ET) tube, marking the final step in liberating a patient from ventilatory support.
Procedure
Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals....
Procedure
Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals....
516
Endotracheal Intubation I: Procedure
986
Endotracheal or ET intubation is a critical medical procedure used to secure a patient's airway, often in acute respiratory distress, apnea, upper airway obstruction, ineffective clearance of secretions, high risk for aspiration, or during general anesthesia.
The ET tube comprises various components, including a standard adaptor to attach a bag-valve-mask (BVM) or ventilator, a cuff, a pilot balloon, and radiopaque markings along its length to measure the insertion distance. The tube sizes...
The ET tube comprises various components, including a standard adaptor to attach a bag-valve-mask (BVM) or ventilator, a cuff, a pilot balloon, and radiopaque markings along its length to measure the insertion distance. The tube sizes...
986
Endotracheal Intubation II: Nursing Management
545
Endotracheal intubation is a critical procedure that can be lifesaving for many patients with respiratory distress or failure. The role of nursing in managing endotracheal tubes is pivotal, as it involves pre-intubation preparation, assisting during the procedure, and post-extubation care.
1. Nursing Care of Patients Before Intubation
Before the endotracheal intubation procedure, nurses play an essential role in ensuring the process goes smoothly. The nurses must be familiar with intubation...
1. Nursing Care of Patients Before Intubation
Before the endotracheal intubation procedure, nurses play an essential role in ensuring the process goes smoothly. The nurses must be familiar with intubation...
545
Oxygen Delivering System II: Venturi Mask and Transtracheal Oxygen
445
Oxygen therapy is a pivotal aspect of medical care, particularly for patients with respiratory ailments. Two prominent oxygen-delivering systems include the Venturi mask and the transtracheal oxygen catheter.
Venturi Mask
The Venturi mask, named after the Venturi effect, is designed to deliver precise oxygen concentrations. It consists of a large tube with an oxygen inlet that narrows down, causing a pressure drop that pulls air in through adjustable side ports. The mask is a lightweight,...
Venturi Mask
The Venturi mask, named after the Venturi effect, is designed to deliver precise oxygen concentrations. It consists of a large tube with an oxygen inlet that narrows down, causing a pressure drop that pulls air in through adjustable side ports. The mask is a lightweight,...
445
Tracheostomy Decannulation
140
Tracheostomy decannulation is a significant milestone in the liberation of mechanically ventilated patients. Despite its importance, there is no universally accepted protocol for this procedure. This demands an evidence-based, individualized approach.
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...
140
Endoscopic Studies II: Thoracocentesis
224
Thoracentesis(Thoracocentesis), commonly known as pleural tap, is a medical procedure where a 22 gauge needle is inserted into the pleural space, the area between the lung and chest wall. This procedure is commonly performed to diagnose or treat various respiratory disorders.
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
224


