一个多学科的质量改进项目导致改善了患者的随访和过器检索率
Lihao Qin1, Feng Tian1, Kai Wang1
1Department of Interventional and Vascular Surgery, The Affiliated Changzhou Second People's Hospital of Nanjing Medical University, Changzhou, China.
Annals of vascular surgery
|December 28, 2024
概括
急性脑出血和缺乏必要的随访是下腔静脉 (IVC) 过器放置后失去患者的关键风险. 一个质量改进项目显著提高了这些患者的IVC过器随访和检索率.
科学领域:
- 血管外科 血管外科
- 提高质量 提高科学 提高质量
- 患者安全 患者安全
背景情况:
- 下腔静脉 (IVC) 过器用于预防高风险患者的肺栓塞.
- 在IVC过器放置后失去后续 (LTFU) 可能导致并发症和减少检索率.
- 识别LTFU的风险因素对于改善患者护理至关重要.
研究的目的:
- 在接受IVC过器的其他部门 (IOD) 的住院患者中确定LTFU的独立风险因素.
- 评估质量改进 (QI) 项目的影响,以追踪和检索率的IVC过器在IODs.
主要方法:
- 在2021年3月至2023年3月期间接受可检索IVC过器放置的患者的回顾性分析.
- 在前QI实施 (n=81) 和后QI实施 (n=77) 组之间的LTFU和过器检索率的比较.
- 统计分析以确定前QI组中LTFU的独立风险因素.
主要成果:
- 急性脑出血 (OR=5.745) 和不需要推部门的随访 (OR=3.435) 是LTFU的独立风险因素.
- 与前QI组相比,后QI组显示出明显更高的过器检索率 (94.8% vs 69.1%) 和较低的LTFU率 (5.2% vs 30.9%) (P<0.001).
- 检索时IVC穿孔的发生率在后QI组中较低 (0%vs9.6%;P=0.019).
结论:
- 急性脑出血和缺乏后续检查的需求是具有IVC过器的IOD中LTFU的重要风险因素.
- 实施的QI项目有效地改善了这一患者群体的随访和IVC过器检索率.
- 在血管干预中,QI倡议对于提高患者安全和护理结果至关重要.
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