在不同的医疗保健环境中停止使用二:质量改进倡议
Frances Carr1,2, Andrea Gruneir3, Jeffrey Chow4
1University of Alberta Hospital, Edmonton, Alberta, Canada fcarr@ualberta.ca.
BMJ open quality
|January 6, 2026
概括
这项质量改进倡议旨在减少长期护理中的二 (BZD) 处方. 虽然出现了挑战,但该干预措施在减轻BZD方面表现有前途,突出了进一步研究和员工教育的需要.
科学领域:
- 老年人药理学 老年人药理学
- 提高质量 提高科学 提高质量
- 患者安全 患者安全
背景情况:
- bensodiazepine (BZD) 使用对老年人构成风险,但它们经常被处方,特别是在长期护理 (LTC).
- 由于患者的脆弱性,减少LTC中的BZD处方至关重要.
- 专注于患者的干预措施在其他地方已经取得了成功,但在LTC环境中还没有得到充分的研究.
研究的目的:
- 实施和评估以患者为中心的多组件干预措施,以在LTC设施中将BZD处方减少50%.
- 评估BZD处方率,剂量和频率的变化.
- 探索实施挑战和患者/工作人员的结果.
主要方法:
- 一个为期17个月的质量改善计划在埃德蒙顿LTC设施.
- 干预包括药剂师主导的药物审查,咨询,患者/工作人员教育和信息资源.
- 结果措施集中在BZD处方变化上;过程和平衡措施跟踪实施和副作用.
主要成果:
- 该倡议减少了BZD的使用,尽管由于招聘和设施挑战,没有达到目标样本规模.
- 所有10名参与者都接受了干预,其中一些人经历了BZD抑郁症.
- 员工教育课程受到了很好的关注和接收; 财务成本是最小的.
结论:
- 质量改进计划表明,尽管存在实施障碍,但BZD在LTC中的使用量有所减少.
- 工作人员教育似乎是未来干预措施的关键组成部分.
- 需要进一步的研究周期来评估LTC环境中干预的充分有效性和可持续性.
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