改善神经外科患者的术后护理,通过尿导管安置的标准化方案:一个多中心的前后实施研究
Jeanne-Marie Nollen1, Anja H Brunsveld-Reinders2, Ewout W Steyerberg3
1Neurosurgery, Leiden Universitair Medisch Centrum, Leiden, The Netherlands j.m.nollen@lumc.nl.
BMJ open quality
|April 24, 2025
概括
实施统一的协议显著减少了神经外科患者不适当的尿路导管治疗. 这一战略通过减少导管使用和促进不那么侵入性的医疗保健实践,改善了患者的护理.
科学领域:
- 神经外科 神经外科
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 改善医疗保健 改善医疗保健
背景情况:
- 尿管导管在神经外科术术前和术后护理中很常见.
- 实践的变化和不适当的导管导致诸如尿路感染和长时间住院等并发症.
- 神经外科患者经常接受导管治疗,因此需要优化护理策略.
研究的目的:
- 通过适当的尿路导管治疗,改善神经外科患者的术后护理.
- 为了减少这一患者群体不适当和整体导管治疗的发生率.
- 将导管实践与以患者为中心,少入侵的医疗保健原则保持一致.
主要方法:
- 在荷兰四家医院 (2021年6月至2023年1月) 进行了一项多中心的前后研究.
- 包括成人神经外科患者进行垂体瘤或脊髓融合手术.
- 实施多方面的战略:统一的协议,教育和部门冠军.
主要成果:
- 不恰当的住房导管装置从54%降至43%;不恰当的干净间歇性导管装置从66%降至33%.
- 总体而言,导管的使用减少,不接受住院 (54%至64%) 或干净间歇性 (89%至92%) 导管的患者增加.
- 尿路感染率和住院时间长度在各组之间保持相似.
结论:
- 一种统一的协议有效地减少了神经外科患者的不适当和整体尿道导管.
- 标准化的协议和持续的教育对于以患者为中心,少入侵的护理至关重要.
- 需要进一步的研究来评估实施的战略的长期可持续性.
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