儿科紧急护理协调员的存在和儿科护理质量措施
Margaret E Samuels-Kalow1, Rebecca E Cash1, Kenneth A Michelson2
1Department of Emergency Medicine, Massachusetts General Hospital, Boston.
JAMA network open
|December 18, 2024
概括
儿科紧急护理协调员 (PECCs) 并没有始终与改善儿科紧急护理质量有关. 它们的存在显示出与成像利用的可变关联,表明它们在需要进一步研究的临床过程中的潜在作用.
科学领域:
- 紧急医疗 紧急医疗
- 儿科护理 儿科护理
- 改善医疗保健质量 改善医疗保健质量
背景情况:
- 更高的儿科准备与更好的儿童医疗保健质量和结果有关.
- 儿科紧急护理协调员 (PECC) 是儿科准备的关键,但它们对质量措施的影响还不清楚.
研究的目的:
- 通过使用护理质量指标,调查PECC存在与急诊室 (ED) 绩效之间的关联.
- 分析PECC如何影响儿科急诊护理中的特定护理质量指标.
主要方法:
- 一项队列研究分析了来自8个州858家医院的数据,包括国家和州ED数据库和2019-2021年的调查.
- 医院根据儿科资源的可用性进行了分层. 多层次的通用线性模型根据患者和ED水平的因素进行调整,以评估PECC的存在与7个护理质量指标相比.
主要成果:
- 在4,645,937次儿科访问中,PECC的存在因医院资源水平而异 (88%的高资源对比13%的无资源).
- 在非儿科资源医院 (AOR 0.76) 和儿科资源医院 (AOR 0.85) 中,PECC与头部CT用于头部创伤的减少有关.
- PECC与儿童医疗医院的喘胸部放射减小相关 (AOR 0.77),但与非儿童医疗医院的胸部放射减小相关.
结论:
- PECC的存在与儿科急诊室的所有护理质量措施并不一致.
- PECC显示出与成像利用的可变关联,表明对临床护理过程的潜在影响.
- 需要进一步的研究,以阐明PECCs在遵循指南和改善儿科患者治疗结果中的作用.
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