中亚儿童医疗质量改进项目的长期成果:变化需要时间,改变需要时间
Sophie Jullien1, Shamsov Bakhtovar Abdulkhafizovich2, Rabiia Allakhveranova3
1Quality of care and patient safety office, World Health Organization, Athens, Greece.
Journal of global health
|March 28, 2025
概括
世界卫生组织 (WHO) 的质量改善项目在吉尔吉斯共和国和塔吉克斯坦加强了儿童医院护理. 只有在吉尔吉斯共和国,临床实践的改善是长期持续的,这凸显了卫生系统因素的重要性.
科学领域:
- 全球健康 全球健康
- 儿科医学 儿科医学
- 改善医疗保健质量 改善医疗保健质量
背景情况:
- 2012-2014年,世界卫生组织 (WHO) 的质量改善 (QI) 项目在吉尔吉斯共和国和塔吉克斯坦实施.
- 该项目旨在通过培训,供应和监督提高儿科医院护理的质量,从而降低儿童死亡率.
研究的目的:
- 评估世卫组织QI项目的长期成功,以改善吉尔吉斯共和国和塔吉克斯坦儿童医院护理的临床实践.
- 在项目完成7年后,评估改善的临床实践的可持续性.
主要方法:
- 使用了一种准实验性设计,将干预医院与对照医院相匹配.
- 对患有急性呼吸道感染或腹住院的儿童 (2-59个月) 的医疗记录进行了2012年,2015年和2021年的审查.
- 临床实践与世卫组织在项目培训期间强调的标准进行了评估.
主要成果:
- 在吉尔吉斯共和国,护理质量的显著改善 (减少不必要的住院/抗生素,增加脉冲氧计/ORS使用) 持续到2021年.
- 在塔吉克斯坦,2015年的初步改善在2021年没有持续下去,一些指标恢复到基线.
- 与干预医院相比,对照医院的改善不那么实质和持续.
结论:
- 该QI项目在改善临床实践方面取得了成功,但长期可持续性在各国之间存在差异.
- 可持续性的差异可能与卫生系统因素 (如治理,融资和劳动力) 有关,这些因素未被充分解决.
- 解决更广泛的卫生系统环境因素对于确保儿科护理质量改善举措的长期影响至关重要.
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