在部骨折患者中改善术后认知评估文档:质量改进项目
Nicholas Tse Hao Ng1, Sally Li Er Fong1
1Trauma and Orthopedics, King's Mill Hospital, Sherwood Forest Hospitals NHS Foundation Trust, Sutton-in-Ashfield, GBR.
Cureus
|August 25, 2025
概括
工作人员的教育提高了对关节骨折患者认知评估文档的遵守,但完全遵守仍然是一个目标. 及时评估对于预防这一易受伤害群体的术后妄想至关重要.
科学领域:
- 老年医学
- 提高质量
- 患者安全
背景情况:
- 国家卫生和护理卓越研究所 (NICE) 的指导方针建议对关节骨折患者进行术后认知评估.
- 简化心理测试分数 (AMTS) 和4A测试 (4AT) 是认知评估的标准工具.
- 在骨骨折患者中遵守这些评估的文档协议对于最佳护理至关重要.
研究的目的:
- 评估和加强骨骨折患者的简化心理测试得分 (AMTS) 和4A测试 (4AT) 的记录.
- 评估教育干预对提高文档率的影响.
- 在此患者群中确定术后妄想的发生率.
主要方法:
- 一个涉及两个审计周期的未来质量改进项目.
- 收集有关患者人口统计,AMTS和4AT文档的遵守情况以及术后妄想的数据.
- 在审计周期之间实施教育干预 (海报).
主要成果:
- 初步遵守AMTS文档的比例为78. 9%,干预后增加到96. 7%.
- 术后的AMTS记录从94. 7%提高到86. 7%,而4AT记录从47. 4%增加到60. 0%.
- 在第二个周期中,20%的患者出现了术后妄想,突出显示了持续的挑战.
结论:
- 提高员工对骨骨折患者认知评估文档的坚持是有效的.
- 尚未完全遵守AMTS和4AT文档协议.
- 术后妄的持续存在强调需要进行一致和及时的认知评估以改善患者的结果.
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