改善抗生素给药时间在有风险的儿科人群:一个质量改善项目
Journal of emergency nursing
|September 20, 2025
概括
这项质量改进倡议成功地缩短了儿童败血症患者服用抗生素的时间. 该研究确保了80%以上的高风险儿童在60分钟内获得关键抗生素,改善了患者的安全.
科学领域:
- 儿科急救医学 儿科急救医学
- 提高质量 提高科学 提高质量
- 传染病管理 传染病管理
背景情况:
- 细菌性败血症对患有状细胞病,瘤病或伴有发烧的中性质衰竭的儿科患者构成严重威胁.
- 对这些高风险患者来说,及时服用抗生素至关重要,但许多医院仍难以达到60分钟的基准.
- 延迟治疗可能会导致不良后果,强调需要有效的干预措施.
研究的目的:
- 实施和评估质量改善计划,以增加高风险儿科患者在急诊室注册后60分钟内接受抗生素的比例.
- 为了实现至少80%的符合60分钟的抗生素给药目标的儿童败血症患者.
- 确定持续改善及时提供抗生素的关键驱动因素.
主要方法:
- 一个计划-做-研究-行动 (PDSA) 模型被用于质量改进计划.
- 通过电子医疗记录审计收集数据,重点关注从急诊室注册到抗生素给药的时间.
- 统计分析,包括使用SPSS 27的2比率z测试,用于评估抗生素治疗时间的改善.
主要成果:
- 该倡议在2022年1月至2024年5月期间对儿科败血症患者及时给予抗生素显著改善.
- 在60分钟内接受抗生素的患者比例从44.4%增加到86.7%.
- 在瘤病患者 (45.2%至90%),血液病患者 (42.9%至81.6%) 和状细胞病患者 (44%至85.1%) 观察到特定的改善.
结论:
- 质量改善倡议成功提高了儿童败血症抗生素的及时性.
- 到2024年5月,86.7%的患者在目标60分钟内接受了抗生素,预测到2024年将达到95%.
- 赋予护理人员权力和实施以团队为基础的策略是实现和维持这些积极结果的关键因素,导致更安全的患者护理.
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