处方时间限制对重症监护室酸盐管理的影响:前后质量改善研究
Rajiv Rooplalsingh1, Felicity Edwards2,3, Julia Affleck4
1Department of Anaesthesia, Royal Brisbane and Women's Hospital, Brisbane, QLD 4029, Australia.
Healthcare (Basel, Switzerland)
|August 9, 2024
概括
实施对酸盐处方的24小时时间限制显著减少了重症监护室 (ICU) 不适当的酸盐管理. 这项质量改进倡议改善了处方实践,但没有对患者的治疗结果产生负面影响.
科学领域:
- 关键护理医学 关键护理医学
- 临床药房 临床药房
- 提高质量 提高质量
背景情况:
- 在重症监护室 (ICU) 处方酸盐需要仔细监测,以确保患者的安全和适当的治疗.
- 以前的处方做法可能导致对血清酸盐水平正常或高的患者给予酸盐,这表明需要质量保证.
研究的目的:
- 评估对电子酸盐处方24小时时间限制对处方模式的影响.
- 为了评估接受酸盐补充剂的患者比例的变化,尽管血清酸盐度正常或高.
主要方法:
- 一项多中心质量保证研究在澳大利亚三个成年ICU中进行.
- 在临床信息系统内,对电子酸盐处方实施了24小时的时间限制.
- 患者数据,包括血清酸盐水平,酸盐给药和结果,在干预前后进行了比较.
主要成果:
- 在接受酸盐治疗的患者中,正常或高血清酸盐水平的比例在干预后显著下降,从30.3%降至9.9% (p < 0.001).
- 在对潜在混因素进行调整后,这种减少仍然很大 (调整后的赔率比:0.214,p < 0.001).
- 在ICU停留时间,住院死亡率或出院目的地方面没有发现显著差异.
结论:
- 引入电子酸盐处方的24小时时间限制有效地减少了ICU中不适当的酸盐管理.
- 这项质量改善措施改善了处方实践,但没有对关键患者的治疗结果产生不利影响.
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