在质量计划中应用集团决策模型,以提高药物安全性
Rosana Aparecida Pereira1, Fernanda Raphael Escobar Gimenes2
1University of São Paulo at Ribeirão Preto College of Nursing, WHO Collaborating Centre for Nursing Research Development, SP, Brazil.
Florence Nightingale journal of nursing
|May 14, 2025
概括
实施集团决策模型显著改善了对药物管理协议的遵守,特别是对于粉碎药片的技术. 这种参与式的方法增强了医疗保健机构的质量改进实践.
科学领域:
- 改善医疗保健质量 改善医疗保健质量
- 护理实践 护理实践
- 药物管理安全 药物管理安全
背景情况:
- 遵守药物制备和服药协议对于患者的安全至关重要.
- 短期肠道接入装置通常用于药物输送.
- 现有的质量改进方法在决策过程中可能存在局限性.
研究的目的:
- 评估集团决策模型对遵守药物管理协议的影响.
- 为了比较一个计划-做-研究-行动 (PDSA) 周期的有效性,并没有组决策模型.
- 加强在护理中的质量改进实践的实施.
主要方法:
- 量化研究方法遵循质量改进报告卓越标准 (SQUIRE) 的指导方针.
- 在第四个PDSA周期内实施集团决策模型.
- 第三个PDSA周期 (没有集团决策模型) 和第四个PDSA周期 (有集团决策模型) 之间的坚持率的比较.
- 在巴西圣保罗的一家临床医疗病房进行的研究 (2018年6月 - 2019年4月).
主要成果:
- 集团决策模型显著提高了成功实施质量改进的可能性.
- 通过集团决策模型,对药丸粉碎技术的遵守率从5.3%增加到100%.
- 与上下决策过程相比,参与式方法显示出更好的结果.
结论:
- 计划-做-研究-行动循环是提高质量的宝贵工具,但可以通过自上而下的决策来限制.
- 通过集团决策模型纳入参与阶段,大大提高了药物管理质量改进的成功实施.
- 该模型显示了通过肠道接入装置改善口服药物管理的巨大潜力.
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