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为患有病的儿科患者制定过渡计划
Sahar Siddiqui1, Cortney Taylor Zimmerman2, Brittany Garza1
1Baylor College of Medicine/Texas Children's Hospital, Department of Pediatrics, Division of Nephrology, 1102 Bates Ave., Ste. 245, Houston, TX 77030, USA.
Health care transitions
|December 23, 2024
概括
一个新的结构化医疗保健过渡 (HCT) 计划改善了儿童病患者转移到成人服务的护理. 两步诊所和专门的团队提高了患者的自我管理技能和提供者的满意度.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 儿科医疗保健 儿科医疗保健
- 医疗保健服务研究 医疗服务研究
背景情况:
- 从儿科到成人医疗保健的过渡为患有病的患者带来了重大挑战.
- 不充分的过渡过程可能会加剧年轻成年人与疾病相关的发病率.
- 需要一个结构化的方法来确保对这些脆弱患者的护理连续性.
研究的目的:
- 为患有脏疾病的儿科患者制定和实施结构化医疗保健过渡 (HCT) 计划.
- 为了解决非标准化HCT工艺的识别障碍.
- 在过渡到成人护理期间改善患者的结果和满意度.
主要方法:
- 利用质量改进方法来建立一个跨学科的过渡团队.
- 进行了需求评估,以确定有效HCT的障碍.
- 实施了一个联合的,两步过渡诊所 (儿科和成人),具有标准化的政策和反机制.
主要成果:
- 27名患者完成了过渡诊所的第一步,22人完成了第二步.
- 大多数患者 (41%) 接受过脏移植,平均过渡年龄为20岁.
- 100%的患者接受过渡政策并报告提高了自我管理技能;100%的科医生对该计划感到满意.
结论:
- 一个结构化的HCT程序,开发了一个专门的团队,成功建立和受欢迎.
- 该计划代表了对儿童病患者过渡到成人医疗保健的标准化护理的关键进展.
- 这些发现强调了该计划在提高患者准备和提供者满意度方面的有效性.
相关概念视频
01:11Renal Failure: Dose Adjustments
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In patients with renal impairment, drugs undergo significant changes in their pharmacokinetics, which require dosage adjustments to ensure safe and effective therapy.
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
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01:28Renal Drug Excretion: Tubular Secretion
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Active tubular secretion is a robust, energy-demanding process that utilizes carrier systems to transport drugs into renal tubules. The active renal secretion systems include the organic anion transporter (OAT) for weak acids and the organic cation transporter (OCT) for weak bases. Structurally similar drugs can compete for the same transporter, potentially leading to drug accumulation and toxicity. However, this principle can be exploited therapeutically. One example is probenecid (Probalan),...
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01:27Dialysis
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Renal failure occurs when the kidneys lose their ability to filter waste products from the blood effectively. It can be classified into two types: acute renal failure (ARF) and chronic renal failure (CRF).
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01:25Renal Drug Excretion: Tubular Reabsorption
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Tubular reabsorption, a process occurring post-glomerular filtration of drugs in the renal tubule, is a critical determinant of drug half-life. During the process of renal excretion, as the glomerular filtrate progresses to the distal convoluted tubule (DCT), drugs that are highly permeable, lipophilic, and nonionized undergo passive reabsorption from the tubular fluid into the surrounding peritubular capillaries. This reabsorption process restricts their elimination through the kidneys. This...
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01:17Factors Affecting Renal Clearance: Renal Impairment
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Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
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01:15Renal Drug Excretion: Overview
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As primary excretory organs, the kidneys maintain homeostasis by removing waste substances from the bloodstream. They comprise over a million units called nephrons, which serve as the kidney's functional units.
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