为长期严重疾病的成年人提供质量改进工具的代码设计:修改后的德尔菲共识研究
Laura Allum1,2, Natalie Pattison3,4, Bronwen Connolly2,5,6,7
1Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, United Kingdom.
Critical care explorations
|September 12, 2024
概括
为长期重症患者开发了一种新的质量改进 (QI) 工具. 该工具侧重于可操作的护理流程,包括患者参与和结构化康复,以提高长期住院重症监护室 (ICU) 幸存者的结果.
科学领域:
- 关键护理医学 关键护理医学
- 患者安全 患者安全
- 改善医疗保健质量 改善医疗保健质量
背景情况:
- 长时间的重症监护室 (ICU) 停留时间正在增加.
- 现有的质量改进 (QI) 工具并不适合长期重症患者,可能导致不理想的护理和结果.
- 需要专门的QI干预措施来满足这种患者群体的独特需求.
研究的目的:
- 为了建立一个QI工具对关怀的基本可操作流程的共识.
- 为长期严重疾病的成年人开发一个QI工具.
- 提高重症病患的安全性和标准化护理,以延长ICU停留时间.
主要方法:
- 基于经验的共同设计过程,涉及患者,家庭和临床医生.
- 两轮在线修改的Delphi调查,以评估护理用品的重要性.
- 一次最终的共识会议,以优先考虑QI工具的项目.
主要成果:
- 招募了116名参与者 (医疗保健专业人员,患者,亲属).
- 在最初确定的39个项目中,32个项目被超过70%的德尔菲参与者投票评为"至关重要".
- 最终的QI工具包括25个项目,强调患者/家庭参与,护理连续性和结构化康复.
结论:
- 基于经验的共同设计和共识方法成功确定了长期严重疾病的QI工具的关键内容.
- 开发的QI工具包含了改善这一患者群体护理的关键要素.
- 需要进一步的研究来评估该工具的可接受性和最佳实施策略.
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