通过高风险的圆形化过程,减少儿科重症监护室中医院获得的疾病
Sara Galt1, Laura Barg-Walkow2, Heather Bennett3
1Sara Galt is a clinical practice specialist in the pediatric intensive care unit (PICU) and a quality improvement leader, Children's Hospital Colorado, Aurora.
Critical care nurse
|January 31, 2026
概括
在儿科重症监护室实施高风险检查,显著减少了医院获得的病症46.5%. 这项质量改进计划在两年内证明了持续的积极的患者安全结果.
科学领域:
- 儿科重症监护室的儿童重症监护室
- 提高质量 提高科学 提高质量
- 患者安全 患者安全
背景情况:
- 医院获得的疾病 (HAC) 对重症儿童构成重大风险.
- 预防HAC是儿童重症监护室 (PICU) 患者安全的关键组成部分.
- 随着COVID-19大流行,预防HAC的挑战加剧了.
研究的目的:
- 在PICU中实施和评估一项新的跨专业高风险圆形化计划.
- 为了减少在医院获得的特定疾病的发生率.
- 改善单位的工作文化,解决增加的HAC率.
主要方法:
- 实施了一项高风险圆形化计划,目标是对HACs最敏感的患者.
- 轮次包括编写问题,随后是有针对性的教育和资源获取.
- 测量质量改善结果是中央线路相关的血液感染率,导管相关的尿路感染率,无计划的输出管和压力损伤.
主要成果:
- 在两年内,对488名患者进行了624轮治疗,导致351次干预.
- 接受高风险疗程的患者患HAC的可能性显著降低 (χ2 = 22.5,P < .001).
- 项目特定HAC的发生率下降了46.5%,从每1000个患者日的5.41事件降至2.89事件,估计有50个HAC被阻止.
结论:
- 跨专业高风险圆形化计划有效地减少了医院在PICU中获得的条件.
- 观察到的HACs的减少在项目的两年持续时间内持续.
- 这一举措突显了积极主动的,跨专业轮次在提高患者安全方面取得的成功.
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