在重症儿科患者中减少急性损伤:针对毒药物暴露的质量改善项目
Natalie Capretta1, Diana Zepeda-Orozco2,3,4, W Joshua Frazier1
1Division of Critical Care Medicine, Nationwide Children's Hospital, Columbus, OH.
概括
一项质量改善倡议减少了暴露于毒药物 (NTM) 的重症儿童的急性损伤 (AKI). 药剂师主导的教育和每日警报显著降低了NTM暴露率和NAKI率.
科学领域:
- 儿科重症监护医学 儿科重症监护医学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 提高质量 提高科学 提高质量
背景情况:
- 毒药物 (NTM) 是重症儿科患者急性损伤 (AKI) 的重要危险因素.
- 需要进行结构化的干预措施,以减轻儿科重症监护室 (PICU) 中的NTM相关的AKI (NAKI).
研究的目的:
- 降低重症儿童因毒药物暴露而导致的AKI的发生率.
- 实施和评估一个质量改善 (QI) 倡议,针对在PICU中使用NTM.
主要方法:
- 一个前性的,多阶段的QI项目在四级护理儿童医院进行.
- 干预措施包括药剂师主导的教育,信息手册和每日临床药剂师对NTM暴露的通知.
- 在干预之前和之后收集了NTM暴露率和NAKI率的数据.
主要成果:
- NTM暴露率下降了12.4% (每1000个患者日中从30.6到26.9).
- 与NTM相关的AKI (NAKI) 率显著降低了55% (每1000个患者日5.6至2.5).
- 这项研究在20个月的时间内包括了34,631个患者日.
结论:
- 有针对性的QI干预,包括教育和药房警报,有效地减少了重症儿科患者的NTM暴露和NAKI.
- 药房驱动的通知和利益相关者教育是NTM管理的关键组成部分.
- 目前正在努力的重点是这些成功的战略的制度整合和可持续性.
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