改善医院 Delirium 查和文档.
Stephanie Chambers1, Renu Bhargavi Boyapati, Rachel Gagliasso
1Stephanie Chambers, Rachel Gagliasso, and Christopher Kohler are instructors in nursing, Renu Bhargavi Boyapati is a research fellow in the Division of Hospital Internal Medicine, Linda Griebenow is an assistant professor of nursing, Shant Ayanian is an assistant professor of medicine, and Sandeep Pagali is an associate professor of medicine, all at Mayo Clinic, Rochester, MN. The scientific publications staff at Mayo Clinic provided copyediting support. Contact author: Stephanie Chambers, chambers.stephanie@mayo.edu. The authors have disclosed no potential conflicts of interest, financial or otherwise.
在日常护理文档中添加妄想查显著改善了坚持,提高了超过50%的患病率. 这项质量改进倡议提高了护士与临床医生的沟通和患者安全,而不会影响其他评估.
科学领域:
- 提高质量 提高质量
- 患者安全 患者安全
- 医疗保健管理的管理
背景情况:
- 痴呆症查对住院患者至关重要,影响结果和安全.
- 梅奥诊所发现,人们对妄查和记录方案的遵守率很低 (25.9%).
- 解决这些差距对于改善护理标准至关重要.
研究的目的:
- 确定缺口和导致妄查遵守率低的原因.
- 设计和实施干预措施,以至少提高50%的查文档率.
- 确保干预措施不会对其他护理评估产生负面影响.
主要方法:
- 一个多学科团队使用六西格玛方法来进行质量改进项目 (2022年5月至2023年4月).
- 干预措施包括简要混评估方法 (bCAM) 的EHR重组,护士教育和最佳实践咨询 (BPA).
- 痴呆症查被整合到轮班文档提醒中;压力损伤风险评估作为一个平衡措施.
主要成果:
- 在整合到轮班提醒 (P < 0.001) 后, Delirium 查文档显著增加,从 25.9% 增加到 47.7%.
- 在EHR中,BPA与临床医生捕捉妄诊断的47%的增加相关.
- 压力损伤风险评估率保持稳定,表明对其他评估没有不利影响.
结论:
- 将 Delirium 查纳入班次文档,大大提高了班次遵守率,超过了 50% 的目标.
- 最佳实践咨询改善了临床医生对妄诊断的识别和记录.
- 这些干预措施显示了通过改善妄想管理来提高患者的治疗结果和安全的潜力.
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