一个质量改进项目,以减少新生儿重症监护病房的意外输出
Adelaide B Caprio1, Krystle N Niewinski, Sara Murphy
1Division of Nursing, Rush University Medical Center, Chicago, Illinois (Ms Caprio and Dr Niewinski); Department of Cardiopulmonary Sciences, Division of Respiratory Care, Rush University Medical Center, Chicago, Illinois (Mss Murphy and Geistkemper); and Department of Pediatrics, Division of Neonatology, Rush University Medical Center, Chicago, Illinois (Dr Seske).
一个标准化,由护士领导的护理包在新生儿重症监护室 (NICU) 显著减少了非计划性输出. 这项质量改善计划实现了零EU率,改善了婴儿安全和护理.
科学领域:
- 新生儿重症监护室 (NICU) 质量改善
- 新生儿护理中的患者安全
- 医疗保健管理和干预
背景情况:
- 计划外抽 (UE) 是新生儿重症监护室 (NICU) 经常发生的不良事件.
- 由于新生儿的特定生理需求,内管 (ETT) 管理在新生儿中是复杂的.
- 减少UE对于最小化并发症和优化资源利用至关重要.
研究的目的:
- 降低城市III级NICU的非计划性输出管 (UE) 率.
- 设定一个目标UE率小于0.5每100通风器日.
- 实施质量改进项目,以提高患者的安全性和护理.
主要方法:
- 开发一个基于证据的,标准化的,护士主导的护理包,用于输管和ETT管理.
- 实施明确的,闭环的沟通协议,用于员工的过渡.
- 组建一个跨专业团队来监督项目.
主要成果:
- 每100个呼吸机日,UE率从0.76下降到0.
- 该项目成功实现了每100个通风器日不到0.5个UEs的目标.
- 这项干预从2021年12月到2022年2月的10周时间内实施.
结论:
- 一个标准化,由护士领导的护理包有效地减少了NICU中的UE.
- 这个倡议突出了结构化协议对婴儿安全的影响.
- 建议进行进一步的研究,以评估对其他单位和人群的概括性.
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