可以预防的住院和护理
Katherine E Di Palo1, Deepa Jayaram2, Lilia Cervantes3
1Department of Medicine, Division of Hospital Medicine, Montefiore Medical Center, Bronx, NY.
Clinical journal of the American Society of Nephrology : CJASN
|September 2, 2025
概括
患有脏疾病的住院是常见的且昂贵的, 但很多病是可以预防的. 解决患者,提供者和系统层面的因素可以减少这些事件并改善病患者的护理.
科学领域:
- 肝脏病学
- 医疗保健管理
- 公共卫生
背景情况:
- 患有脏疾病的人患病率高达38%,高于一般人群.
- 美国每年医院住院费用超过1300亿美元.
- 许多住院,包括再入院,是可以预防的,提供了减少负担和成本的机会.
研究的目的:
- 审查不同类别的病可预防住院的驱动因素:急性损伤 (AKI),慢性病 (CKD) 和功能衰竭.
- 探索针对可预防住院风险的多层次护理模式的证据.
- 检查激励这些护理模式的联邦计划.
主要方法:
- 在AKI,慢性病和衰竭中预防住院的司机的文献综述.
- 分析多层次护理模式及其有效性.
- 对护理模式的财政激励计划进行审查.
主要成果:
- 共同的驱动因素包括临床复杂性,自我管理困难,临床惯性,对病的不充分认识和分散的护理.
- 具体机制因病类型而异 (例如,CA-AKI与HA-AKI,慢性病并发症,衰竭液过载).
- 诸如门诊护理,多学科合作,过渡护理和自我管理支持等策略可以减少住院.
结论:
- 患有病的可预防住院病例是由患者,提供者和系统层面的因素决定的.
- 多层次干预和支持性护理策略对于降低住院率至关重要.
- 政策和财政激励可以鼓励采用有效的护理模式.
相关概念视频
Acute Kidney Injury IV: Diagnostic Studies and Prevention
57
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
57
Acute Kidney Injury V: Interprofessional Care
44
Acute Kidney Injury (AKI) requires a collaborative healthcare approach to restore renal function and prevent complications. Essential management strategies involve monitoring fluid and electrolyte balance, adjusting medications, initiating dialysis when necessary, and providing nutritional support.Fluid and Electrolyte ManagementFluid Monitoring: Regularly monitoring body weight, central venous pressure, and urine output helps detect fluid imbalances early. Patient intake and output are...
44
Healthcare Associated Infections II: Preventive Measures
2.8K
Essential infection prevention measures are based on the knowledge of the infection chain, the modes of transmission in healthcare settings, and the use of the best practices in all healthcare settings. Compulsory public reporting of healthcare-associated infection rates is needed to allow individuals and the community to make informed choices regarding selecting a healthcare facility.
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
2.8K
Chronic Kidney Disease III: Interprofessional Care
77
Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
77
Chronic Kidney Disease IV: Nursing Management
54
Nursing management is essential for preventing complications, maintaining stability, and improving patients' quality of life in chronic kidney disease (CKD). By using a structured approach, nurses help slow CKD progression and support effective patient care.1. Comprehensive patient assessmentEffective management begins with nurses reviewing the patient’s medical history, and identifying key risk factors like diabetes, hypertension, and nephrotoxic drug use. Nurses assess signs of...
54
Acute Kidney Injury VI: Nursing Management
57
Acute Kidney Injury (AKI) results in an inability to maintain fluid, electrolyte, and acid-base balance. Effective nursing management is critical in improving patient outcomes and includes comprehensive patient assessment and targeted interventions.Comprehensive Patient AssessmentA detailed history collection is essential, focusing on any recent infections, nephrotoxic medication use, or chronic conditions such as hypertension and diabetes that may contribute to AKI. During the physical...
57


