在接受肠道手术的婴儿中减少生长障碍:质量改善倡议
Julie D Thai1, Jessica Liu2,3, Caroline Toney-Noland2,3
1Department of Pediatrics, Division of Neonatology, Fetal and Neonatal Institute, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
JPEN. Journal of parenteral and enteral nutrition
|May 12, 2025
概括
这项质量改进项目旨在减少肠道手术后婴儿的生长障碍. 尽管营养实践得到了改进,但生长障碍仍然存在,这凸显了对营养提供和其他因素的进一步研究的需要.
科学领域:
- 新生儿护理 新生儿护理
- 外科手术的结果
- 儿童营养学 儿童营养学
背景情况:
- 接受肠道手术的婴儿面临着严重的生长障碍风险.
- 启动了一项质量改进计划,以减少20%的增长障碍在这个弱势群体中.
- 目标是在12个月内实现并维持这种减少.
研究的目的:
- 评估一项多站点质量改进项目的有效性,以减少肠道手术后婴儿的生长障碍.
- 评估遵守营养指南和养实践的变化.
- 在干预期间监测关键安全指标.
主要方法:
- 八个新生儿重症监护室 (NICU) 参与了为期12个月的质量改善项目 (2021年1月至2023年6月).
- 该研究测量了体重z-score与出生体重相比的下降,作为主要结果,并遵守门营养,营养轮和养指南作为过程措施.
- 使用控制图表分析数据,并实施多站点学习会话和本地QI策略.
主要成果:
- 在积极干预阶段,增长障碍保持在25%.
- 遵守亲肠道营养指南的比例从49%增加到68%,养指南从28%增加到68%.
- 在可持续性阶段,生长障碍略有恶化至27%,尽管对肠道营养的坚持达到95%.
结论:
- 质量改进项目成功地提高了护理婴儿肠道手术后的NICU的营养相关实践.
- 尽管营养护理得到了改善,但首要的结果 - - 减少生长障碍 - - 没有实现.
- 未来的研究应该调查营养递送,人体测量和影响这些婴儿生长的非营养因素.
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