使用结构化干预来指导病房巡回是否会影响患者的结果? 一个系统的审查
Victoria Ando1,2, Alexia Cavin-Trombert3,4, David Gachoud2,5
1Department of Internal Medicine, Etablissements Hospitaliers du Nord Vaudois, Yverdon-les-Bains, Switzerland Victoria.ando1@gmail.com.
BMJ quality & safety
|April 29, 2025
概括
床边病房巡视 (BWRs) 期间的结构化干预措施对患者死亡率或感染没有明确的影响. 需要更多高质量的研究来确定它们真正的临床益处.
科学领域:
- 临床医学 临床医学
- 医疗保健管理的管理
- 提高质量 提高质量
背景情况:
- 病房巡视对于患者护理至关重要,但缺乏标准化.
- 结构化的干预措施可以提高效率,文档和在轮次期间的沟通.
- 这些结构化干预措施对患者临床结果的影响仍然不确定.
研究的目的:
- 系统地审查床边病房巡视 (BWRs) 期间结构化干预措施对患者临床结果的影响.
- 评估有关对死亡率,感染并发症,停留时间和通风持续时间的影响的证据.
主要方法:
- 在多个数据库 (Embase,Medline,CINAHL,ERIC,Web of Science,Cochrane Library) 进行系统的搜索和引用搜索.
- 包括在BWR期间对结构化干预的同行评审研究及其对住院病人的临床结果的影响.
- 不包括船上学习,教学或药物循环.
主要成果:
- 包括29项研究,2项RCT和27项准实验研究.
- 没有观察到对死亡率,停留时间或尿路和中线相关血流感染率的显著影响.
- 对于呼吸机相关的肺炎和机械通风的持续时间存在相互矛盾的证据,有改善的潜力.
结论:
- 在BWR期间结构化干预对临床患者结果的影响目前尚不确定.
- 需要更高质量的研究,包括多中心RCT或精心设计的前性试验.
- 需要进一步的研究来澄清结构化病房周的临床益处.
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