实施活动和流动性促进方法以改善患者流动性
Shweta Gore1, Karen Mattie, Kara Schworm
1Shweta Gore is associate professor at the MGH Institute of Health Professions, Charlestown, MA. Karen Mattie is senior director of clinical operations, Kara Schworm is rehabilitation director, Sheila Murphy is an NP, Carolyn Googins is director of quality and patient safety, and Lisa Caruso is physician geriatrician, all at Boston Medical Center. Mary Slavin is director of education and dissemination at the Boston University School of Public Health. Daniel Young is an associate professor at the University of Nevada, Las Vegas. This project was supported by the National Institutes of Health award no. 1P2CHD101895-01 through the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the National Institute of Nursing Research. The authors acknowledge Nicole Lincoln, MSN, RN, FNP-BC, CCNS, Deborah A. Whalen, MBA, MSN, APRN, Julie Murray, OTR/L, Sabine Clasen, PhD, MSN, RN, and Keshrie Naidoo, EdD, DPT, PT, for their critical review of the manuscript. Contact author: Shweta Gore, sgore@mghihp.edu . The authors have disclosed no potential conflicts of interest, financial or otherwise.
实施约翰霍普金斯活动和移动促进 (JH-AMP) 计划显著减少住院患者的不移性. 这项质量改进计划证明了可行性,并改善了患者流动的结果.
科学领域:
- 改善医疗保健质量 改善医疗保健质量
- 患者流动性的研究.
- 在医疗保健中的实施科学.
背景情况:
- 住院患者经常经历运动能力下降,导致不良结果,特别是在老年人中.
- 低患者流动性与功能衰退和医疗保健成本增加有关.
- 需要有效的策略来促进在住院期间的流动性.
研究的目的:
- 实施和评估约翰霍普金斯活动和流动性促进计划 (JH-AMP) 的可行性.
- 检查JH-AMP计划对安全网医院患者流动性的初步影响.
- 通过提高流动性来改善患者的治疗结果,并降低医疗保健成本.
主要方法:
- 在医疗,外科和ICU单位中采用了实施前后研究设计.
- 该JH-AMP计划利用了基于"将研究转化为实践"框架的八个策略,为所有患者设定了日常流动目标.
- 移动性措施,包括AM-PAC"6-Clicks"简体表格和JH-HLM尺度,被整合到EHR中.
主要成果:
- 在实现后,在获得约翰霍普金斯最高水平移动性 (JH-HLM) 评分为4或更高的患者中观察到显著增加 (P = 0.043).
- 在所有单位 (P = 0.031) 中,在JH-HLM尺度上得分为1 (躺在床上) 的患者比例显著下降.
- 该计划证明了大规模,系统的全医院实施的可行性.
结论:
- 系统的,全医院实施活动和流动性促进计划是可行的.
- 该JH-AMP程序可以显著减少住院患者的不运动.
- 促进患者的流动性对于改善结果和降低相关成本至关重要.
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