减少计算机断层扫描在儿科急诊室评估尾炎的使用:一个多学科的质量改善倡议
Jennifer Hockenbury1, Monica E Lopez2, Caroline M Godfrey2
1From the Division of Pediatric Emergency Medicine, University of Louisville, Louisville, Ky.
Pediatric quality & safety
|May 20, 2025
概括
一项质量改善计划成功地将计算机断层扫描 (CT) 用于儿童尾炎评估的使用率从31.3%降至12.1%. 这种持续减少CT扫描并没有对患者的结果产生负面影响.
科学领域:
- 儿科手术 儿科手术
- 放射学 放射学是一门学科.
- 提高质量 提高科学 提高质量
背景情况:
- 尾炎是一种常见的儿科手术紧急情况.
- 计算机断层扫描 (CT) 在诊断儿科尾炎时经常被过度使用.
- 机构CT使用率超过同行医院的使用率.
研究的目的:
- 在12个月内,将儿童尾炎评估的CT利用率从31.3%降至15%.
- 实施多学科质量改进倡议.
主要方法:
- 从2021年9月到2022年10月,在儿科急诊室 (PED) 进行了一项质量改善计划.
- 干预措施包括临床实践指南,电子医疗记录订单组用于决策支持,以及标准化的超声波报告.
- 用统计过程控制图表分析数据.
主要成果:
- 总共有2,010名患者被评估为尾炎.
- CT利用率从基线的31.3%下降到12.1%,持续了10个月.
- 没有观察到对负面病理尾切除率或72小时复诊的显著影响.
结论:
- 质量改进方法可以有效地减少儿童尾炎诊断中的CT利用率.
- 在不影响患者安全或诊断准确性的情况下,可以实现持续减少CT扫描.
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