系统更换后在大都市ED中使用机械控制装置的比较:一个前后分析
Jaislie La Barrass1, James L Mallows1,2, Mark D Salter1,2
1Nepean Hospital Emergency Department, Penrith, New South Wales, Australia.
Emergency medicine Australasia : EMA
|February 12, 2025
概括
通过实施新的策略,Nepean ED通过实施新的策略,减少了心理健康患者的机械约束. 镇静剂的使用增加,而镇静剂的持续时间和比例减少,表明患者护理得到改善.
科学领域:
- 紧急医疗 紧急医疗
- 精神病学是一个精神病学.
- 改善医疗保健质量 改善医疗保健质量
背景情况:
- 在此之前,Nepean ED对心理健康 (MH) 患者的机械约束率很高.
- 机械约束可以对患者和工作人员造成严重的创伤.
- 启动了一个项目,通过远程精神病学,文化变革,教育和降级技术来减少克制的使用.
研究的目的:
- 为了比较心理健康患者在质量改善计划之前和之后的机械约束情节.
- 该研究特别分析了2019年和2021年的数据,这是2020年干预实施一年后的数据.
主要方法:
- 对需要机械约束的精神健康患者进行回顾性队列分析.
- 从电子医疗记录和ED限制登记册中收集的2019年和2021年的数据.
- 在两年间,限制情节,持续时间和镇静剂使用的比较.
主要成果:
- 尽管2021年MH病例增加了11.5%,但经历克制的MH患者比例从8.8%降至6.3%.
- 平均控制时间从385分钟大幅减少到229分钟.
- 在被控制的患者中,镇静的使用率从58.6%增加到72.9%.
结论:
- 实施的变化导致了心理健康患者机械束的使用和持续时间的减少.
- 增加了镇静剂的使用与减少的克制情节一起观察到.
- 这些发现表明,在ED中管理MH患者的质量改善计划取得了成功.
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