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Updated: May 29, 2025

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实施"同一个夜晚"尾切除术 (SNAppy) 免费协议:质量改善倡议
Joshua K Ramjist1, Benjamin Carr2, Kimberly Aitken Menezes3
1Division of General and Thoracic Surgery, The Hospital for Sick Children, Toronto, ON, Canada; Department of General and Thoracic Surgery, Temerty Faculty of Medicine, University of Toronto, ON, Canada.
Journal of pediatric surgery
|February 7, 2025
概括
一项新的协议显著减少了尾切除术患者的住院时间,将住院时间从11.2小时减少到1.5小时,而不会增加急诊室返回. 这简化了对不复杂的尾炎的护理.
科学领域:
- 儿科手术 儿科手术
- 外科手术的结果
- 提高质量 提高质量
背景情况:
- 尾切除术是一种治疗尾炎的疗法.
- 长时间住院治疗无并发性尾炎往往是不必要的.
- 在尾切除术后需要有效的出院协议.
研究的目的:
- 实施和评估一项协议,以加快患者尾切除术后的出院.
- 为了减少儿童尾切除术患者的停留时间 (LOS).
- 评估对急诊室 (ED) 返回和住院病床利用的影响.
主要方法:
- 利用多个计划-做-研究-行动 (PDSA) 周期来开发和完善排放协议.
- 实施了手术前,手术期间和手术后的护理修改.
- 测量了手术后的LOS,ED回报率和住院病床利用率.
- 使用统计过程控制图表和曼·惠特尼U测试进行分析.
主要成果:
- 总共分析了332名患者 (147名协议前,185名协议后).
- 术后的中位数LOS显著下降,从11.2小时降至1.5小时 (P < 0.00001).
- 在ED回报率上没有显著差异 (6.8%的前协议与9.2%的后协议,P = 0.65).
- 68%的患者在实施后直接从手术室出院,而在实施前为0%.
结论:
- 该SNAppy协议显著减少了手术后停留的时间.
- 住院病床利用率下降,但急诊室返回人数没有增加.
- 该协议有效地简化了接受尾切除手术的儿科患者的护理.
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