通过实施AARC临床实践指南,改善气管切除术患者的治疗结果
Candice J Devlin1, Rory S O'Bryan1, Hope Williams2
1Mss. Devlin and O'Bryan are affiliated with Department of Speech-Language Pathology, Duke Regional Hospital, Duke University Health System, Durham, North Carolina.
Respiratory care
|November 12, 2024
概括
一个跨学科的气管切除术团队通过实施指导方针来改善患者护理. 这导致了急性护理机构中增加了语音语言病理学和说话门的脱和咨询.
科学领域:
- 关键护理医学 关键护理医学
- 肺部病理学 肺部病理学
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
背景情况:
- 随着COVID-19的流行,需要气管切除术的患者数量显著增加.
- 针对美国呼吸系统护理协会 (AARC) 2021年1月临床实践指南 (CPG),审查了空气管切除护理的现有机构协议.
- 确定了急性护理气管切除术管理的改进机会,促使成立了一个专门的团队.
研究的目的:
- 评估跨学科气管切除团队和AARC CPG实施对患者结果的影响.
- 评估关键绩效指标的变化,与急性护理环境中的气管切除术护理相关.
主要方法:
- 从2019年6月到2023年6月进行了一项质量改进研究,比较了干预前后组.
- 成立了一个跨学科的气管切除组来管理患者并执行AARC CPG建议.
- 分析的指标包括停留时间,呼吸机日,脱,死亡率,再入院和治疗咨询.
主要成果:
- 该研究包括203名患者 (94名干预前,109名干预后).
- 在幸存的非COVID患者中,脱的百分比显著增加 (11.8%与33.3%,P=.043).
- 对于语音语言病理学 (53.2% vs 89.0%,P<.001) 和单向说话 (17.0% vs 32.1%,P=.02) 的咨询也显著增加.
结论:
- 建立一个跨学科的气管切除术团队对患者的护理产生了积极的影响.
- 实施AARC CPG建议导致关键结果的统计学上显著改善.
- 这些发现支持一种结构化,以团队为基础的方法,在急性护理环境中进行气管切除术管理.
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