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改善儿科重症监护病房的同情性输出实践
Elizabeth Rinaldi1, Debbie Brostoff2, Robin V Klein3
1Department of Anesthesiology Critical Care Medicine, Children's Hospital Los Angeles (E.R., R.V.K., M.C.W.), Los Angeles, California, US.
Journal of pain and symptom management
|October 12, 2025
概括
一个新的协议通过标准化文档和通信,改善了儿科重症监护室的同情性输出管 (CE) 护理. 这提高了重症儿童的终身护理,提高了提供者的满意度.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 改善医疗保健的质量.
- 生命终端护理协议
背景情况:
- 儿科重症监护室 (PICU) 和心胸重症监护室 (CTICU) 的同情性输出管 (CE) 实践的变化导致了不一致的护理.
- 缺乏CE标准化程序影响了症状管理,文档和提供者之间的沟通.
研究的目的:
- 实施和评估一个旨在标准化同情性输出管 (CE) 实践的协议.
- 改善症状管理,文档准确性和医疗保健提供者在儿科重症监护机构的CE活动期间之间的沟通.
主要方法:
- 一个质量改进项目,涉及CE协议的实施,包括标准化订单检查清单和测试后汇报工具.
- 进行了干预前 (2020年1月至12月) 和干预后 (2022年2月至2023年1月) 的图表审查和工作人员调查.
- 包括医生,护士,呼吸治疗师和息护理专家在内的多学科团队监督了该项目.
主要成果:
- 在适当的输出管外置订单 (6%至69%) 和及时提前护理计划文件 (89%至100%) 中观察到显著的改善.
- 静脉活性输注在输出时的停止率从78%增加到100%.
- 工作人员报告了超过90%的积极反关于CE期间患者和提供者的舒适性,表明对该协议的高度满意.
结论:
- 实施的同情性输出管 (CE) 协议有效地提高了儿科生命终端护理的文档和沟通.
- 建议进行进一步的研究,以识别和解决对进行术后汇报的障碍,以优化CE过程.
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