创建和实施全关节关节整形手术的医院同一天出院计划
Jessica N Pelkowski1,2,3,4,5,6,7, Jennifer M Traverse1,2,3,4,5,6,7, Ronnie N Owen1,2,3,4,5,6,7
1Jessica N. Pelkowski, DNP, APRN, AGPCNP-BC, ONP-C, FNAON, Department of Orthopedic Surgery, Mayo Clinic, Jacksonville, FL.
Orthopedic nursing
|April 1, 2025
概括
在一年内,实施全关节整形术 (TJA) 的当日出院 (SDD) 从19%增加到71%. 这一举措成功提高了TJA的当天出院率,而不会影响30天的再入院.
科学领域:
- 整形外科手术 整形外科手术
- 提高质量 提高科学 提高质量
背景情况:
- 专注于减少原发性全关节关节整形手术 (TJA) 的住院时间.
- 在从仅限住院患者的列表中删除后,门诊关节切除的增加.
研究的目的:
- 提高初级TJA患者在术后第0天 (POD 0) 出院的比例.
- 在POD 0排放方面,目标是将51%的排放量从19%增加到70%.
- 确保对30天的再入院没有不良影响.
主要方法:
- 使用了DMAIC (定义,测量,分析,改进,控制) 质量改进框架.
- 基于不断改进流程的实施和完善干预措施.
- 监测POD 0出院率和30天的医院再入院.
主要成果:
- 在90天后,POD 0的排放率增加到41%.
- 在干预后的一年,POD 0的排放率达到71%的水平.
- 30天的住院再接收人数保持不变.
结论:
- 可以安全地实施基于TJA同日出院 (SDD) 的麻醉后护理单位的TJA同日出院计划.
- 患者的安全至关重要,无论出院时间 (SDD或一夜之间).
- 项目成功取决于明确的目标,多学科的团队和利益相关者的参与.
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