输血相关的循环过载:对大型教学医院风险评估实践的回顾性审计
1Liverpool University Hospitals NHS Foundation Trust, UK.
概括
输血相关的循环过载 (TACO) 风险评估经常被遗漏或不准确,尽管对患者安全至关重要. 需要改善医疗保健专业人员的培训,以加强输血期间的文档和预防TACO.
科学领域:
- 输血医学 输血医学
- 患者安全 患者安全
- 临床审计 临床审计
背景情况:
- 输血相关的循环过载 (TACO) 是输血相关死亡的一个重要原因.
- 建议对所有接受输血的患者进行TACO风险评估.
- 根据2022年SHOT报告,英国对TACO风险评估的遵守率特别低 (35.6%).
研究的目的:
- 评估大型教学医院中TACO风险评估的合规性和准确性.
- 发现TACO风险评估实践中的差距.
- 为改善输血期间患者安全的策略提供信息.
主要方法:
- 从2022年11月到2023年12月,对44个输血途径进行了回顾性审计.
- 对TACO风险评估的纸质和电子病例记录的审查.
- 对2022年SHOT指南和患者医疗记录的准确性评估.
主要成果:
- 59%的审查途径已经完成了TACO风险评估,41%缺乏任何评估.
- 完成的评估中有12%是不准确的.
- 50%的未经评估的路径被确定为有TACO风险的路径.
- 门诊区域的完成率 (43%) 与住院区域 (16%) 相比较高.
结论:
- 很大一部分患者没有接受输血前TACO风险评估.
- 完成评估中的不准确与错过的风险或不足的缓解计划有关.
- 加强医疗保健专业人员的培训对于改善输血期间的文档和患者安全至关重要.
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