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用脑内膜治疗治疗的肺感染的质量改善举措
Riham Elmahboubi1, Catherine Robitaille2, Céline Dupont3
1Division de Pneumologie, Hôpital de Saint-Jérôme, Saint-Jerome, Quebec, Canada.
对肺感染管理的质量改善举措减少了对手术的需求,改善了肺内疗法和胸部排水实践. 然而,停留时间,死亡率和治疗延迟情况没有变化.
科学领域:
- 肺部病理学 肺部病理学
- 关键护理医学 关键护理医学
- 改善医疗保健质量 改善医疗保健质量
背景情况:
- 胸腔感染的管理是复杂的,并与高死亡率相关.
- 护理过程的指标,如管理延迟和治疗管理至关重要,但往往被忽视.
- 审计发现了我们机构在肺部感染护理过程中的重大缺陷.
研究的目的:
- 评估实施质量改进举措对成年人流管理的影响.
- 评估干预后临床结果和护理过程指标的变化.
主要方法:
- 在 (2013-2016) 和在 (2020-2021) 质量改善干预措施之前,对患者进行肺部感染治疗的回顾性比较.
- 干预措施包括新的胸腔排水和胸腔内治疗政策,护士的治疗和更新的指南.
- 测量的主要结果是停留时间,死亡率,手术治疗和护理过程指标.
主要成果:
- 手术治疗的发生率从14%降至0% (P=0.01).
- 使用较小的排水管 (<12 F) 显著减少 (51%至7%,P<0.001),排水堵塞减少 (20%至2%,P=0.004).
- 脑内静脉治疗的使用情况有所改善,协议的遵守更好,错过的剂量更少;护士的使用率增加到70%.
结论:
- 多方面的质量改善举措加强了肺内治疗和胸部排水实践,用于肺感染.
- 这些干预措施使得手术干预的需要大大减少.
- 住院时间,死亡率和治疗延迟没有受到实施的变化的显著影响.
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