周末对基于证据的护理效应在重症监护室实施基于检查清单的护理之前和之后的坚持:一项跨国研究
Aysun Tekin1, Pien Swart2, Laure Flurin3
1Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.
在重症监护室 (ICU) 的周末护理变化会影响遵守基于证据的流程. 一个检查清单改善了整体遵守,但并没有消除所有周末在护理交付中的差异.
科学领域:
- 关键护理医学 关键护理医学
- 改善医疗保健质量 改善医疗保健质量
- 患者安全 患者安全
背景情况:
- 重症监护室 (ICU) 的人员和资源可用性可能会影响遵守基于证据的护理流程和患者的治疗结果.
- 潜在的"周末效应"可能会影响护理提供和患者的结果,需要对其影响和缓解策略进行调查.
研究的目的:
- 评估是否存在周末影响,以证据为基础的护理流程和ICU住院结果的遵守.
- 评估是否实施检查清单可以减轻周末/假日和工作日入院之间的护理流程和结果的潜在差异.
主要方法:
- 对急性疾病和伤害早期识别和治疗检查清单 (CERTAIN) 研究数据集进行了后期分析.
- 分析了来自15个国家的34个ICU (2013-2017) 的数据,比较了周末/假日入院与周日入院的护理流程和结果,无论是在检查清单实施之前还是之后.
- 主要结局是遗漏了10个基于证据的护理过程;次要结局包括死亡率和停留时间.
主要成果:
- 在干预前,胃潰瘍預防在周末被忽略了更多,而床頭升高在平日被忽略了更多.
- 干预后,胃潰瘍預防的省略率正常化,但周末增加了床頭升高的省略,周末增加了口腔護理的省略.
- 在周末/假日和工作日入院之间,无论是在干预前还是后,都没有发现死亡率或停留时间的显著差异.
结论:
- 周末效应显然影响了ICU中的特定护理流程的遵守.
- 检查清单的实施导致了整体遵守率的改善,但导致了新的差异的出现,同时减少了其他差异.
- 对组织,文化和时间因素的进一步研究对于优化在所有时间和环境中一致的护理提供至关重要.
更多相关视频
08:25Polar Histogram Visualization of Acute Stress Disorder Scale Scores for Comprehensive Clinical Assessment
Published on: December 6, 2024
06:28E-Patient Counseling Trial E-PACO: Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
相关概念视频
Methods of Documentation V: CBE
In CBE, healthcare professionals establish predefined standards of practice that define what constitutes...
Methods of Documentation VI: Case Management Model
For example, a patient with a chronic...
Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
Nursing Implementation
The five steps to implementing effective nursing care include reassessing the patient, reviewing and revising the existing nursing care plan, organizing the resources and care delivery, anticipating and preventing complications, and implementing nursing interventions.
Documentation in Long-Term and Home Healthcare Setting
Long-Term Care Facilities
Nursing Clinical Information System
A Nursing Clinical Information System (NCIS) is a specialized type of healthcare information system tailored to meet the unique needs of nursing practice. It incorporates the principles of nursing informatics to streamline information management and improve the quality of care delivery.
Critical attributes of NCIS include:
