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到ABG或不到ABG-减少在重症监护中不适当的动脉血液气体检测
Juhi Rajan Patel1, Heather Jones1, Henry Houghton1
1Department of Critical Care, Russell's Hall Hospital, the Dudley Group NHS Foundation Trust, Dudley, UK.
一项教育和指导干预措施显著减少了重症监护中不必要的动脉血液气体 (ABG) 测试. 这项质量改善计划降低了成本,临床医生的时间和环境影响,而不会影响患者的安全.
科学领域:
- 关键护理医学 关键护理医学
- 质量改进科学 质量改进科学
- 医疗保健的可持续性 医疗保健的可持续发展
背景情况:
- 动脉血液气体 (ABG) 测试在重症监护机构中经常被过度使用.
- 不必要的ABG测试导致医疗保健成本增加,阳性贫血,以及工作人员浪费时间.
- 此外,与资源消耗和过度ABG测试造成的废物相关的环境负担也很大.
研究的目的:
- 评估基于教育和指导方针的干预措施在减少英国重症监护室 (ICU) 内不适当的ABG测试方面的有效性.
- 进行三重底线评估,评估财务,运营和环境影响.
主要方法:
- 在23个床位的III级ICU中进行了干预前后质量改善项目.
- 在床边教学和视觉提示的同时,实施了当地ABG指南.
- 质量改进中的可持续性 (SusQI) 框架指导了可持续性原则的整合.
主要成果:
- 总体ABG测试减少了34.4%,不适当的测试减少了22.9% (NNT=4.4).
- 观察到显著的节约:直接成本为2781.90英,临床医师时间为210.8小时,血液为1396升,二氧化碳排放量为124.0公斤.
- 没有发现对患者护理的不良影响.
结论:
- 低成本,由护士领导的干预有效地减少了不必要的ABG测试,提高了患者安全,并带来了巨大的财务,运营和环境效益.
- 将可持续性指标整合到质量改进中,加强了实践变革的理由,并支持NHS净零议程.
- 通过指导方针和教育赋予重症监护护士权力是改善ABG管理和促进可持续医疗保健的关键.
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