一个手术室到重症监护室的交接不仅仅是握手:一个质量改进项目
Shannon Kirk1, Aisling Coffey, MeganLynn Duffy
1Author Affiliations: Cardiothoracic Surgery, NYU Langone Health, New York, New York (Kirk, Coffey, Duffy); Cardiothoracic Surgery, NYU Langone Health, New York, New York (dos Reis); Nursing Research and Program Evaluation, NYU Langone Health, New York, New York (Dr Zavotsky); and Division of Critical Care Anesthesiology, KP-14 Cardiothoracic Unit and CVICU, Department of Anesthesiology, Perioperative Care and Pain Medicine, NYU Langone Health, NYU Grossman School of Medicine, New York, New York (Dr Jan).
在心胸重症监护室 (CTICU) 实施结构化交接流程,提高了患者转移的效率和有效性. 这项由护士主导的倡议优化了工作环境和患者的结果,预计每年将大大节省成本.
科学领域:
- 医疗保健管理的管理
- 患者安全 患者安全
- 提高质量 提高质量
背景情况:
- 有效的跨学科合作对于最佳的患者护理至关重要,特别是在重症监护室 (ICU).
- 患者交接过程是分享影响患者结果的重要信息的关键时刻.
- 高可靠性组织原则指导过程,以提高重症监护机构的安全性和效率.
研究的目的:
- 开发,实施和评估一个结构化的交付流程,用于在成人心胸重症监护室 (CTICU) 的手术后恢复阶段.
- 提高直接从手术室 (OR) 转移到CTICU的患者的效率,有效性和工作环境.
- 通过标准化沟通和角色明确性,提高提供者准备能力和患者过渡.
主要方法:
- 在学术医疗中心 (AMC) 的CTICU中进行了一项由护士领导的5个月质量改进项目.
- 开发和实施全面的交付流程,包括员工位置地图和专门的交付工具.
- 实施前和之后的单位特定数据的分析,包括员工工作流满意度调查和财务影响评估.
主要成果:
- 结构化的移交过程减少了OR患者周转时间,提高了移交的效率和有效性.
- 在护理点改善提供者准备,为术后患者提供无过渡.
- 通过维护动脉压监测系统,避免中断,预计每年节省2550万美元.
结论:
- 实施的护士驱动的移交过程显著提高了CTICU的效率,有效性和工作环境.
- 标准化沟通,明确的角色和废弃物消除促进了团队对安全和交付期间适应能力的更大信心.
- 持续的再评估和多学科教育对于维持患者转变和结果的改善至关重要.
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