实施急性尾炎的紧急整形外科护理途径:质量改善倡议
Abby R Gross1, Sayf Al-Deen Said1, Jeffrey Claridge1
1Department of General Surgery, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Surgical infections
|October 17, 2025
概括
一个新的护理途径成功地增加了急性尾炎患者的窄谱抗生素使用. 这项质量改进倡议加强了抗生素管理,但没有对临床结果或成本产生负面影响.
科学领域:
- 传染性疾病 传染性疾病
- 改善临床质量 改善临床质量
- 卫生系统管理管理卫生系统管理
背景情况:
- 急性尾炎的治疗依赖于抗生素和尾切除术,但抗生素的选择和持续时间各不相同.
- 广谱抗生素的使用普遍存在,尽管指南建议使用狭谱抗生素.
- 对急性尾炎的抗生素管理缺乏效率需要标准化的护理途径.
研究的目的:
- 实施和评估标准化护理途径,以加强急性尾炎的抗生素管理.
- 增加窄谱抗生素的使用,减少宽谱抗生素的处方.
- 评估该途径对临床结果和医疗保健成本的影响.
主要方法:
- 一个多学科工作组开发了一个基于证据的护理途径,在六家医院实施.
- 分析了1279名患者的数据 (619名干预前,660名干预后).
- 主要结局是经验广泛与狭窄谱抗生素使用;次要结局包括治疗持续时间,停留时间,再入院率和成本.
主要成果:
- 窄谱抗生素的使用显著增加,从14.2%增加到18.5% (p=0.04),广谱使用相应减少.
- 在停留时间,30天再接收率或技术直接成本方面没有发现显著差异.
- 统计过程控制图表表明,在狭窄谱的处方中持续改善.
结论:
- 一个标准化的护理途径有效地改善了急性尾炎的抗生素选择.
- 该干预措施加强了抗生素管理,但没有对患者的治疗结果或成本产生不利影响.
- 这个倡议证明了可扩展的,基于证据的干预措施的可行性,以改善在各种医疗保健环境中使用抗生素.
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