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基于共识的开发和实践测试一种通用质量指标,用于在家中进行肠道药物管理:一项兰德合适性方法研究
Jedidja Lok-Visser1,2, Roald Hunneman3,4, Cecile H J Bekkers5,6
1Center for Healthcare Operations Improvement & Research, University of Twente, Enschede, The Netherlands j.lok-visser@utwente.nl.
BMJ open
|July 1, 2025
概括
为改善患者安全和医疗保健工作者条件,开发了在家中进行亲肠道药物管理 (PMAaH) 的新质量套件. 这一框架有助于医院对PMAaH途径进行基准评估和重新设计,以获得高质量的护理.
科学领域:
- 医疗保健管理的管理
- 患者安全 患者安全
- 药物管理 药物管理
背景情况:
- 随着家庭医疗保健需求的不断增长和护理人员的短缺,需要优化在家中对肠道药物管理 (PMAaH) 途径.
- 现有的PMAaH护理途径表现出复杂性和可变性,突出了对标准化质量框架的需求.
- 缺乏通用的质量指标 (QI) 阻碍了对PMAaH服务的持续监测和改进.
研究的目的:
- 开发一套全面的,通用的质量指标 (QI) 在家中进行亲肠道药物管理 (PMAaH).
- 为 benchmarking 和重新设计 PMAaH 护理途径提供一个框架,以确保高质量的患者护理.
- 解决在日益增长的家庭亲肠道疗法领域对标准化质量评估的需求.
主要方法:
- 采用了系统的RAND适当性方法,包括范围审查以确定潜在的QA.
- 通过在线问卷和会议进行专家小组评级,以评估指标的适当性.
- 在多家医院进行了回顾性实践测试,评估了拟议的质量指标的可行性,清晰性和可衡量性.
主要成果:
- 最后一组32个通用QI (15个结构,17个过程) 建立用于在家中通过肠道给予药物 (PMAaH).
- 开发的质量指标主要关注患者安全和医疗保健工作者的条件.
- 实践测试表明,17.6%的QA已完全实施,运营QA的实施率高于系统QA.
结论:
- 该研究成功开发并验证了在家中进行亲肠道药物管理 (PMAaH) 的通用质量套件.
- 这一质量套件为医院提供了一种有价值的工具,用于对其PMAaH护理途径进行基准评估和重新设计.
- 实践测试证实了这种结构化的质量套件对于改善家庭医疗保健服务的必要性和实用性.
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