提高对NICU以家庭为中心护理的承诺:一个多中心合作质量改进项目
Malathi Balasundaram1,2, Henry C Lee3, Laura C Hedli4
1Division of Neonatal & Developmental Medicine, Stanford University, Palo Alto, CA, USA. malathib@stanford.edu.
在新生儿重症监护室 (NICU) 实施以家庭为中心的护理 (FCC) 通过协作指导和教育得到改善. 这一举措成功地增加了FCC委员会和家庭伙伴关系委员会 (FPC) 的NICU数量.
科学领域:
- 新生儿重症监护室 (NICU) 的护理实践.
- 医疗保健中的质量改善举措
- 实施以家庭为中心的护理 (FCC).
背景情况:
- 以家庭为中心的护理 (FCC) 被认为对新生儿重症监护室 (NICU) 的积极影响.
- 尽管已证明有好处,但FCC并未被一致地作为NICU的护理标准实施.
- 在FCC广泛采用委员会和理事会等FCC结构方面存在差距.
研究的目的:
- 增加新生儿重症监护单位 (NICU) 的百分比,建立了以家庭为中心的护理委员会 (FCC).
- 加强与家庭伙伴关系委员会 (FPC) 配合的NICU的数量.
- 实施和评估一个以FCC采用为重点的质量改进倡议.
主要方法:
- 一个多中心质量改进项目利用了参与NICU的小组合作指导.
- 使用关键驱动图和帕雷托图来识别和解决FCC实施的障碍.
- 主要结果是建立FCC委员会和/或FPC,并采取包括网络研讨会参与在内的过程措施.
主要成果:
- 在22个参与站点,拥有FCC委员会的NICU的百分比从18%上升到59%.
- 在参与的NICU中,FPC的建立从18%增加到45%.
- 每两个月一次的教育网络研讨会的参与度显著增加,平均每次网络研讨会的浏览量从28次增加到182次.
结论:
- 一种协作式指导方法有效地促进了NICU中FCC委员会和FPC的发展.
- 通过网络研讨会提供的有针对性的教育干预措施支持了该倡议的成功.
- 质量改进模型表明,参与NICU的FCC基础设施大幅增加.
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