为心力衰竭住院的成年人质量指标的国际比较:系统性审查
Giliana Garcia Acevedo1, Aisha Ahmad1,2, Benjamin Stall1
1Divisions of Internal Medicine and Palliative Care, Department of Medicine, Temmy Latner Centre for Palliative Care, Sinai Health, Toronto, Ontario, Canada (G.G.A., A.A., B.S., M.M., J.M.L., S.M., K.L.Q.).
关于心力衰竭护理质量指标的国际协议有限. 随访和药物治疗等关键措施缺乏共识,强调改善医院护理质量的机会.
科学领域:
- 心脏病学 心脏病学
- 医疗保健服务研究 医疗服务研究
- 提高质量 提高质量
背景情况:
- 在定义住院心力衰竭患者护理质量方面,国际上存在有限的共识.
- 对于心力衰竭护理的现有质量指标 (QI) 在全球卫生社会中显示出显著的差异.
研究的目的:
- 为了比较和衡量与心力衰竭住院的成年人发表的质量指标之间的一致性.
- 确定心力衰竭护理当前质量测量的共识和差距.
- 为心力衰竭管理制定标准化质量指标提供信息.
主要方法:
- 对住院心力衰竭患者的QI进行系统审查和证据差距地图.
- 在PubMed,MEDLINE,EMBASE和TRIP数据库中搜索到2022年7月.
- 使用Donabedian框架和通过研究和评估 (AIRE) 评估指标进行分析.
主要成果:
- 从代表11个社会的14篇文章中确定了75个独特的QI;53个过程,16个结构,7个结果措施.
- 观察到有限的一致性,只有12%的QA被≥3个社会推.
- 最常见的QA:出院后的随访 (73%),特定的药物治疗 (64%),患者教育 (45%),LVEF评估 (45%),30天再入院 (45%).
结论:
- 在定义住院心力衰竭患者的高质量护理方面存在重大分歧.
- 关键领域如出院后的随访,药物治疗和患者教育缺乏标准化的质量衡量标准.
- 这些发现强调需要在QI上达成更大的共识,以提高心力衰竭护理的质量.
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