质量改进项目,旨在减少ED中不适当使用腹部X射线
Sam Love1, Alexander Mount2, Lucy Kinch2
1Critical Care, East and North Hertfordshire NHS Trust, Stevenage, UK sam.love1@nhs.net.
Emergency medicine journal : EMJ
|August 19, 2024
概括
这项质量改进项目减少了急诊室 (ED) 中不必要的腹部X射线 (AXR). 协调干预成功地减少了AXR的使用,而没有增加CT扫描,证明了一种可重现和具有成本效益的方法.
科学领域:
- 紧急医疗 紧急医疗
- 放射学 放射学是指放射学
- 提高质量 提高质量
背景情况:
- 腹部X射线 (AXR) 在急诊室 (ED) 经常被过度使用,尽管在急性情况下临床价值有限.
- 启动了一项质量改进项目 (QIP),以减少单个中心ED中不必要的AXR利用.
研究的目的:
- 实施和评估一个多学科的干预策略,旨在减少在急诊室使用腹部X射线 (AXR).
主要方法:
- 一个质量改进项目 (QIP) 涉及代的计划-做-研究-行动周期,在一个地区总医院ED.进行了一段定义的时间.
- 干预措施包括教育和系统层面的变化,针对医生订购成人患者的腹部X射线 (AXR).
- 关于AXR和CT扫描使用的数据被收集并分析了干预前和干预期间.
主要成果:
- 在干预期间,每两周腹部X射线 (AXR) 的平均数量从27.5显著下降到17.6,这表明了特殊的因果变化.
- 计算机断层扫描 (CT) 的使用情况保持稳定,在CT腹腔盆腔扫描的数量上没有显著变化.
- 高比例的AXR (76.2%) 没有产生急性或临床意义上的发现,大多数 (90.1%) 仍在进行进一步的成像.
结论:
- 协调,多学科的干预措施有效地减少了在ED环境中不必要的腹部X射线 (AXR) 使用.
- 实施的策略是可重现的,具有成本效益,并且没有导致计算机断层扫描 (CT) 使用率的增加.
- 这项研究为寻求通过质量改进举措优化诊断成像实践的其他部门提供了实用模型.
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