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减少儿童支气管透视麻醉前的禁食时间:一个质量改进项目
Qi Wang1, Lamei Liu1, Shujing Gao1
1Department of Pediatric Respiratory and Immunology Nursing, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China.
概括
一个质量改进项目旨在缩短儿科支气管镜禁食时间,但没有实现整体减少. 文化和家长合作等因素使中国西南部的指导方针实施复杂化.
科学领域:
- 儿科麻醉学 儿科麻醉学
- 提高质量 提高科学 提高质量
- 医疗保健管理的管理
背景情况:
- 在麻醉之前禁食指南对于患者的安全至关重要.
- 在接受支气管镜检查的儿科患者中,优化手术前的禁食时间是一个持续的挑战.
- 实施标准化的禁食协议需要了解当地环境.
研究的目的:
- 为了减少儿童支气管镜术麻醉前的禁食时间.
- 实施和评估一个质量改进项目,重点关注程序前禁食.
- 确定在中国西南地区指导方针本地化的障碍和促进因素.
主要方法:
- 一个质量改进项目,利用卫生服务研究实施的综合促进行动 (i-PARIHS) 框架.
- 雇员特定,可衡量,可实现,相关,时间有限 (SMART) 目标和计划-执行-检查-行动 (PDCA) 周期.
- 进行了障碍分析,并使用了控制图表和数据分析的统计过程控制.
主要成果:
- 该项目涉及830名儿童;新的禁食政策并没有显著减少整体手术前禁食时间.
- 流体饮食 (母乳养,配方奶粉) 的禁食时间减少 (P=.019).
- 禁食时间与手术体积,患者体重和全身麻醉使用相关.
结论:
- 减少儿科支气管镜术的手术前禁食时间是复杂的,因为文化,教育,资源和操作因素.
- 中国西南地区禁食指南的本地化面临着重大实施挑战.
- 需要进一步的有针对性的干预措施来解决影响因素,并优化禁食政策,以改善患者和家庭的体验.
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