实践改进项目:为选择性非心脏手术提供远程手术前评估平台
Joshua Ivare1, David N Tryon2, Adam K Jacob3
1Department of Medicine, Mayo Clinic, Rochester, MN.
Mayo Clinic proceedings. Innovations, quality & outcomes
|September 2, 2025
概括
在手术前进行远程心脏评估是可行的,也是安全的. 这种使用远程医疗的预麻醉医疗评估 (PAME) 方案显示了高患者满意度和最小的并发症,支持其在选择性非心脏手术中的使用.
科学领域:
- 心脏病学
- 麻醉学
- 卫生信息学
背景情况:
- 在手术前对患者进行预麻醉医疗评估 (PAME) 是非常重要的.
- 传统的PAME可能会给患者带来物流上的挑战.
- 远程评估方法可以提高可访问性和效率.
研究的目的:
- 评估远程心脏评估方案的可行性,安全性和患者满意度.
- 评估远程医疗在非心脏手术的麻醉前医学评估中的有用性.
- 为了比较远程和实体PAME的结果.
主要方法:
- 这是一项前性研究,涉及接受非心脏手术的患者.
- 患者使用电子设备远程监测血压和心电图.
- 基于远程医疗的PAME (tPAME) 和面对面的PAME (iPAME) 组之间的比较.
- 分析了手术后的并发症和患者满意度调查.
主要成果:
- 在129名符合条件的患者中,有48人参与 (37.2%的参与率).
- 在tPAME或iPAME组中没有发生重大心血管不良事件.
- 在 iPAME 组中,一名患者出现深静脉血栓/ 肺栓塞;另一名患者接受急诊.
- 患者对他们的PAME体验表示高度满意.
结论:
- 在PAME期间进行远程心脏评估是一种可行的和安全的方法.
- 该方案显示患者满意度很高,支持将其纳入常规护理.
- 基于远程医疗的PAME可以有效地用于选择性非心脏手术.
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