优化儿科创伤成像解释及时性:一个多中心质量改进研究
Ashley N Urban1, Carleen Schneiter, Addison Liska
1Author Affiliations: Department of Radiology, University of Colorado School of Medicine, Aurora, Colorado (Drs Maloney, Meyers, Milla, and Monson); Department of Pediatric Radiology, Children's Hospital Colorado, Aurora, Colorado (Drs Maloney, Meyers, Monson, and Milla, Mss Bushur, and LeBlanc); Division of Pediatric Surgery, Children's Hospital Colorado, Aurora, Colorado (Mss Urban, Martin, Koehler, and Dr Acker); Division of Pediatric Surgery, Children's Hospital Colorado, Colorado Springs, Colorado (Mr Culbertson); Department of Critical Care, Children's Hospital Colorado, Aurora, Colorado (Dr Schneiter); Section of Emergency Medicine, Children's Hospital Colorado, Aurora, Colorado (Drs Anstett, Kim and Ms Liska); Department of Process Improvement, Children's Hospital Colorado, Aurora, Colorado (Ms English); and Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado (Drs Anstett, Schneiter, Kim, and Acker, Mr Culbertson, and Ms Koehler).
实施简化成像协议显著减少了儿科创伤患者的解释时间,改善了护理的一致性而不会影响质量. 这提高了受伤儿童的应急响应.
科学领域:
- 儿科急救医学 儿科急救医学
- 放射学 质量改善 放射学 质量改善
- 创伤护理协议 创伤护理协议
背景情况:
- 对于儿科创伤患者的成像解释有很大的差异,在50%以上的病例中影响了护理.
- 在儿科创伤中延迟放射学解释会导致更长的急诊室停留时间和错过的伤害.
- 由于缺乏标准化的成像协议,严重受伤的儿科患者的及时解释受到阻碍.
研究的目的:
- 评估简化成像协议对图像解释的及时性和一致性的影响.
- 评估协议实施后儿科创伤患者护理的变化.
主要方法:
- 在一级和二级儿科创伤中心进行了干预前后质量改善研究.
- 包括儿童患者 (≤18岁) 满足转诊机构的创伤激活标准.
- 使用统计过程控制图表测量图像解释的及时性和一致性.
主要成果:
- 协议后,翻译时间的中位数从145分钟减少到51分钟.
- 翻译时间的变化明显减少 (SD从680分钟减少到170分钟).
- 在干预之前或之后,没有发现影响患者护理的遗漏伤害.
结论:
- 一个精简的成像协议提高了儿童创伤患者图像解释的速度和一致性.
- 该协议提高了效率,但没有对护理质量或患者安全产生负面影响.
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