消化问题:在摄入外体后出现ED的儿童的护理标准化
Wilhelmina Fouche1, Sinead McDonnell1, Clare Roche2
1Department of Emergency Medicine, University Hospital Galway, Galway, Ireland.
BMJ open quality
|December 8, 2025
概括
一项新的指导方针改善了急诊部 (ED) 的儿科外体摄入管理,将正确治疗率从55%提高到87%以上. 这项质量改善计划还减少了不必要的成像和专家转诊.
科学领域:
- 儿科急救医学 儿科急救医学
- 提高质量 提高科学 提高质量
- 临床指南开发 临床指南开发
背景情况:
- 外体摄入是儿童急诊室访问的常见原因之一.
- 该机构最初的管理层对最佳实践的坚持不够理想 (55%).
- 对于管理这些案件,没有具体的当地指导方针.
研究的目的:
- 实施当地制定的指导方针和教育干预措施.
- 加强对儿科外体摄入管理的最佳实践的遵守.
- 将正确管理率从基准水平的55%提高到80%以上.
主要方法:
- 一个为期5个月的质量改善项目在第三级急诊室.
- 利用三个计划-做-研究-行动 (PDSA) 周期进行代改进.
- 干预措施包括制定指南,传播和基于案例的教育.
主要成果:
- 正确管理显著增加,从基线时的55%增加到干预后的87%-100%.
- 不必要的成像从16%降至12%;不适当的转诊从3%降至0%.
- 可避免的回访从4%降至0%,没有报告的伤害.
结论:
- 当地制定的一项指导方针有效地改善了对儿科外体摄入的最佳实践的遵守.
- 该干预措施对过程措施和患者安全产生了积极影响.
- 通过整合到培训和医院系统中,预计会持续改善.
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