在农村第三级创伤中心设置中改善大规模输血协议响应
Mackenzie B Korsch1, Ginger M Knapp
1Author Affiliations: Patient Care Research (Mrs Korsch), Trauma Program (Ms Knapp), Community Hospital Division of Froedtert Health, West Bend, WI and Menomonee Falls, WI, Wisconsin.
概括
实施一个结构化的大规模输血协议 (MTP) 响应系统,通过加强资源交付和团队协调,改善了农村创伤护理. 沟通和工作流程的挑战仍然存在,需要在这些关键环境中进一步关注.
科学领域:
- 创伤外科 手术 创伤外科
- 紧急医疗 紧急医疗
- 卫生系统管理管理卫生系统管理
背景情况:
- 农村III级创伤中心的大规模输血协议 (MTP) 面临的挑战包括输血延迟,有限的支持和产品浪费.
- 现有的MTP研究主要集中在更高层次的创伤中心,使农村环境受到研究不足.
- 过程中出现的故障,包括人员缺口和交付延迟,需要一个有针对性的MTP响应系统.
研究的目的:
- 评估新实施的MTP激活响应系统的有效性.
- 评估在农村第三级创伤中心的资源交付,团队协调和文档方面的改进.
- 识别尽管系统得到了改进,但在沟通和工作流中存在着持续的挑战.
主要方法:
- 一个质量改进项目,采用用定性方法的描述性设计.
- 从2023年8月到2024年2月,在两个农村中西部的三级创伤中心进行.
- 通过MTP激活后跨学科团队成员的匿名在线问卷收集的数据,使用描述性和叙事性分析进行分析.
主要成果:
- 35名团队成员在8次MTP激活中做出了反应.
- 发现的主要障碍:不准确的页面 (50%),沟通挑战 (62.5%) 和快速输入问题 (50%).
- 积极的结果包括适当的管理 (87.5%) 和高度的文档遵守 (89%的单位文档,83%的订单确认).
结论:
- 一个结构化,多学科的MTP响应系统提高了农村III级创伤中心的资源供应,团队协调和文档.
- 尽管取得了改进,但沟通和工作流的挑战仍然是重大障碍.
- 需要进一步完善MTP响应系统,以优化农村创伤环境中的护理.
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