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加强遵守手术前禁食指南:一个闭环质量改进计划,以优化患者安全和结果
Abubakar I Sidik1, Alexander G Faybushevich1, Md Limon Hossain2
1Cardiothoracic Surgery, Rossiskiy Universitet Druzhbi Narodov (RUDN University), Moscow, RUS.
实施有针对性的干预措施显著改善了在心血管和胸部手术中遵守手术前禁食指南的情况. 这提高了患者的安全性,并通过优化禁食时间来减少并发症.
科学领域:
- 麻醉学 麻醉学
- 手术护理 手术护理
- 提高质量 提高质量
背景情况:
- 术前禁食对于降低麻醉期间吸入风险至关重要,指南建议固体和透明液体的具体持续时间.
- 临床实践往往显示出对这些指导方针的不严格遵守,导致长时间的禁食和消极的患者结果,如脱水和不适.
研究的目的:
- 评估在心血管和胸部外科手术中遵守国际手术前禁食指南.
- 识别合规障碍并实施干预措施,以改善合规性和患者的治疗结果.
主要方法:
- 使用计划-做-研究-行动循环方法的质量改进研究.
- 涉及769名接受选择性手术的患者,进行基线和季度审计.
- 干预措施包括员工培训,患者教育和手术前禁食检查清单.
主要成果:
- 干预后观察到遵守禁食指南的显著改善 (p < 0.001).
- 清晰液体的中位数禁食时间降至4.1小时,固体食物的中位数降至12.0小时.
- 相关的术后并发症,如脱水和低血糖症减少.
结论:
- 有针对性的干预措施可以显著提高对手术前禁食指南的遵守.
- 优化禁食实践可以提高患者的安全性,舒适性和手术结果.
- 持续监测和协议调整对于持续的合规性至关重要.
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