静脉铁染色:来自长期质量改进项目的现实发病率,可预防性和缓解工具
Martin L Canning1, Jodie B Hillen2, Maya Kashiwagi2
1Clinical Governance, Metro North Hospital and Health Service, Level 14 Block 7, Royal Brisbane and Women's Hospital, Cnr Butterfield St and Bowen Bridge Road, Herston, QLD 4029, Australia.
概括
静脉注射 (IV) 铁疗法可能会导致皮肤染色,这是一个可以预防的不良事件. 一个质量改进项目显示,人们越来越多地遵守最佳实践,尽管染色发生率仍然相似,其中86%的染色是可以预防的.
科学领域:
- 临床医学 临床医学
- 患者安全 患者安全
- 提高质量 提高质量
背景情况:
- 缺铁性贫血是一个全球性的健康问题,经常用静脉注射 (IV) 铁治疗.
- 皮肤染色是一种罕见但重要的不良事件,与IV铁疗法相关.
- 实施了一项质量改进项目,以减少IV铁染色对患者的伤害.
研究的目的:
- 评估质量改进项目的对IV铁染色事件的实际影响.
- 评估IV铁染色事件的可预防性.
- 为了确定标准化静脉注射铁程序的有效性.
主要方法:
- 2016年至2022年期间报告的IV铁染色事件的回顾性图表审计.
- 染色发生率,可预防性和染色严重程度在标准化程序实施前后进行比较.
- 对遵守最佳实践原则的分析,包括药剂师审查,同意表格和管位置选择.
主要成果:
- 在七年内,发生了103次静脉注射铁污染,整体发病率为每100次输液0.31次.
- 标准化程序的实施显著改善了药剂师的审查,同意表格的使用和管位置的适当性.
- 虽然整体染色率没有显著变化,但86%的染色被认为是可以预防的,早期干预导致了更小的染色尺寸.
结论:
- 临床实践中IV铁染色的发生率为0.31%.
- 质量改进项目加强了对最佳实践的遵守,强调大多数染色事件是可以预防的.
- 早期识别和干预对于最大限度地减少铁污的尺寸和改善患者的结果至关重要.
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