医疗复杂的婴儿在家过渡:从质量改进工作中吸取的经验教训
Dan Benscoter1,2, Kristin Voos3,4, Christine L Schuler2,5
1Division of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
概括
这项研究旨在减少医疗复杂的婴儿的出院时间和再入院时间. 虽然可以避免的再入院被消除了,但在确保熟练的家庭护理方面面临的挑战影响了整体出院效率.
科学领域:
- 新生儿护理 新生儿护理
- 改善医疗保健质量 改善医疗保健质量
- 儿科医学 儿科医学 儿科医学
背景情况:
- 医疗复杂的婴儿经常面临长时间住院.
- 从新生儿重症监护室 (NICU) 到家庭的过渡可能具有挑战性.
- 再接收对医疗保健系统和家庭造成重大负担.
研究的目的:
- 为了缩短从气管或胃口管安置到家庭出院的时间.
- 减少医疗复杂的婴儿在出院后7天内可避免的再入院.
主要方法:
- 一项涉及五个新生儿科单位和医疗保健支付人代表的合作努力.
- 使用统计过程控制 (SPC) 方法来监测停留时间 (LOS) 和再录取.
- 从手术到确定家庭护理支持的追踪时间.
主要成果:
- 在研究的最后25个月内,没有发生了可以避免的再入院.
- 停留时间 (LOS) 和所有原因的再录取在统计上保持不变.
- 识别家庭护理的中位时间为70.1天,突出显著的瓶.
结论:
- 在25个月的时间内,消除了可以避免的再接收.
- 缺乏熟练的家庭护理护理,阻碍了NICU到家庭过渡的改进.
- 需要进一步的系统级干预,以优化弱势婴儿的出院过程.
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