通过多学科检查清单改善手术内甲状腺激素监测:质量改善倡议
Austin R Swisher1, Justin M Hintze1, Chee-Chee H Stucky2
1Department of Otolaryngology-Head & Neck Surgery, Mayo Clinic, Phoenix, Arizona, USA.
概括
一个新的检查清单显著加快了副甲状腺手术期间的手术内副甲状腺激素 (ioPTH) 测试. 这提高了手术效率,并减少了患者等待关键测试结果的时间.
科学领域:
- 内分泌学 在内分泌学.
- 手术病理学手术病理学
- 改善医疗保健的质量
背景情况:
- 在手术内对甲状腺激素 (ioPTH) 监测对于确认成功的甲状腺外科手术至关重要.
- 在ioPTH测定处理中的延迟可能会延长操作时间,影响手术效率.
- 需要标准化的工作流来优化ioPTH测试过程.
研究的目的:
- 评估多学科检查清单在加快手术内副甲状腺激素 (ioPTH) 测定过程中的有效性.
- 评估检查清单对减少ioPTH测试周转时间和操作时间的影响.
- 为了确定检查清单是否可以提高副甲状腺手术中的工作流效率.
主要方法:
- 开发一个多学科的检查清单,以标准化ioPTH收集和工作流程.
- 使用检查清单 (干预组) 对30名患者进行前性研究.
- 对30名不使用检查清单 (对照组) 的患者进行了回顾性审查.
- 组间对15分钟后ioPTH测定结果的时间间隔进行比较.
主要成果:
- 从样本采集到15分钟后ioPTH结果的平均时间在检查清单组显著减少 (22.2分钟与33.3分钟相比;P <.01).
- 在等待ioPTH结果的比例操作时间随着检查清单 (24.4%对34.1%;P <.01) 显著下降.
- 腺瘤性疾病的总手术时间显著减少,但四腺腺激增症的总手术时间没有显著减少.
结论:
- 实施简单的手术内检查清单有效地减少了ioPTH测定处理时间.
- 检查清单有助于在甲状腺外科手术中实现更有效的外科工作流程.
- 这种低成本的干预措施有望得到更广泛的采用,以优化患者护理.
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