提高儿科急诊室对住院患者转移护理的安全性
Zoe Grabinski1,2, Ellen Duncan1,2, Kavita Patel1,2
1Ronald O. Perelman Department of Emergency Medicine, New York University Grossman School of Medicine, New York University Langone Health, New York, New York.
Pediatrics
|June 4, 2025
概括
在儿科急诊室实施风险分层和跨学科聚集,大大减少了高级呼吸干预和高风险患者的重症监护病房转移. 这有助于在护理过渡期间提高患者的安全性.
科学领域:
- 儿科急救医学 儿科急救医学
- 提高质量 提高科学 提高质量
- 患者安全研究 患者安全研究
背景情况:
- 关怀的转变,特别是从急诊室 (ED) 到住院环境的转变,带来了严重的患者安全风险.
- 患有需要氧气的呼吸系统疾病的儿科患者的脆弱性增加.
- 一种结构化的方法来识别高风险患者并促进跨学科沟通可以改善结果.
研究的目的:
- 实施和评估质量改进计划,以减少高风险儿科呼吸系统患者在ED到住院患者的过渡期间的不良事件.
- 评估风险分层,电子健康记录 (EHR) 可视化和跨学科聚集对患者结果的影响.
主要方法:
- 一个质量改进的倡议进行在第三级护理,学术儿科ED.
- 使用呼吸状况和氧气需求来确定高风险患者.
- 通过EHR跟踪板图标进行数字映射,可视化高风险患者.
- 在患者运输之前,实施了跨学科的床边聚集.
- 结果措施包括升级到先进的呼吸辅助,PICU升级和RRS激活在24小时内.
主要成果:
- 80%的已确定的高风险呼吸系统患者完成了.
- 观察到显著的减少:53.1%较少的先进呼吸干预.
- PICU升级减少了57.8%,RRS激活减少了59.8%.
- 从床上分配到ED离开的时间没有显著变化.
结论:
- 风险分层,EHR可视化和跨学科聚集有效地改善了儿科患者从ED过渡的结果.
- 这一举措增强了超越ED的患者安全,对医院资源产生了积极影响.
- 这些发现表明,在重症监护过渡期间,成功地采取了降低危险的策略.
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