紧急护理中呼吸道感染的第一线治疗减少了差异,这是多机构质量改进合作的结果
Rana E El Feghaly1,2, Brian R Lee1,2, Matthew P Kronman3
1Department of Pediatrics, Children's Mercy Kansas Cityhttps://ror.org/04zfmcq84, Kansas City, MO, USA.
Infection control and hospital epidemiology
|October 16, 2025
概括
质量改善的努力未能减少儿科急性呼吸道感染 (ARI) 的第一线治疗 (FLT) 的差异. 黑人和白人患者之间的抗生素处方差异扩大,表明需要进一步研究公平护理.
科学领域:
- 提高儿科医疗保健质量 提高儿科医疗保健质量
- 卫生公平研究 卫生公平研究
- 抗生素管理的管理.
背景情况:
- 在各种社会经济和人口群体中,医疗保健获取和结果的不平等仍然存在.
- 在儿科急诊诊所 (PUC) 处方急性呼吸道感染的第一线治疗 (FLT) 可能反映了这些更广泛的不平等.
- 质量改进 (QI) 方法提供了一个解决和减少这种差异的框架.
研究的目的:
- 为了减少PUC中常见的ARI的第一线治疗 (ΔFLT) 的差异.
- 解决FLT与种族,种族,语言和保险状况有关的差异.
- 评估QI干预措施对公平的抗生素处方的影响.
主要方法:
- 一项回顾性队列研究分析了来自9个组织的92个PUC网站的数据.
- 干预涉及当地QI团队,因果分析,驾驶员图表和计划-做-研究-行动 (PDSA) 周期.
- 主要结局是社会经济群体之间的DFLT;后勤回归评估了PDSA影响.
主要成果:
- 分析包括了895,604例患者接触.
- 在语言或保险状况方面,没有观察到 ΔFLT 的显著变化.
- 在黑人和白人患者之间记录了有关DFLT的增加,从3.6%增加到5.8%.
结论:
- 尽管针对性地进行了QI干预,但观察到基于种族的FLT差异越来越大.
- 进一步调查至关重要,以了解这些处方差异的根本原因.
- 需要开发有效的干预措施,以促进儿科护理中公平的抗生素处方.
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