婴儿重症监护室的质量改进活动:停止非计划性催化 (SUNX)
Hidehiko Maruyama1, Shoichiro Amari1, Kana Yamada2
1Division of Neonatology, Center for Maternal-Fetal, Neonatal and Reproductive Medicine, National Center for Child Health and Developoment, Tokyo, Japan.
概括
停止非计划性输出管 (SUNX) 项目旨在减少新生儿重症监护室的非计划性输出管 (UE) 率. 虽然在统计学上并不显著,但该项目促进了一种系统的方法来预防UE,保持比率低于推值.
科学领域:
- 新生儿重症监护室 (NICU) 的护理.
- 医疗保健中的患者安全
- 质量改善项目 质量改善项目
背景情况:
- 推的非计划性输出管 (UE) 率为每100个呼吸机日<1天.
- 2020年,UE率 (1.30/100通风器日) 显著增加.
- 阻止非计划性 eXtubation (SUNX) 项目是为了解决这一问题而启动的.
研究的目的:
- 实施和评估SUNX项目的有效性.
- 为了保持一个低的UE率在NICU.
- 系统地防止计划外的输出.
主要方法:
- 从2019年4月到2024年3月收集的关于UE率的数据.
- 使用计划-做-研究-行动周期实施的干预.
- 原因分析确定了关键驱动因素:镇静剂的使用,内管 (ETT) 带的管理和人员配置水平.
- 进行了模拟培训和事件审查.
主要成果:
- 干预后的UE率保持在每100个呼吸机日中的1以下.
- 没有检测到统计学上显著的特殊原因变化.
- 整合到日常NICU实践中的干预要素,包括镇静方案,ETT录音和患者重新定位.
结论:
- 该SUNX项目建立了一个系统的方法,用于UE预防.
- 通过持续的质量改善努力,实现了持续的低UE率.
- 该项目有助于提高NICU的患者安全.
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