改善先手术前肠道养新生儿与先天性心脏病的疾病
Paul B Brandfonbrener1, Katharine G Gorsky2, Catherine Marks3
1Department of Pediatrics, University of California, San Francisco, San Francisco, CA, USA. paul.brandfonbrener@ucsf.edu.
概括
一项新的养方案显著增加了先手术前对患有先天性心脏病 (CHD) 的新生儿的肠道养. 这项质量改进倡议还改善了母乳养率,但没有产生不良影响.
科学领域:
- 新生儿护理 新生儿护理
- 儿科心脏病学 儿童心脏病学
- 质量改进科学 质量改进科学
背景情况:
- 先天性心脏病 (CHD) 影响了许多新生儿,通常需要专门的护理.
- 术前养对于优化患有心血管疾病的新生儿的结果至关重要.
- 目前这些婴儿的养做法可能不足于最佳,需要有针对性的改进.
研究的目的:
- 增强术前肠道养和母乳养率,用于诊断为先天性心脏病 (CHD) 的新生儿.
- 在多学科环境中实施和评估标准化,基于证据的养方案.
主要方法:
- 一个质量改进项目,涉及一个多学科的团队来开发和实施一个手术前养方案.
- 利用了来自儿科心脏病重症监护协作 (PC4) 的数据和对121名新生儿的图表评论.
- 采用统计过程控制图表来分析在实施前,实施和维持阶段的数据.
主要成果:
- 术前肠道养率在实施后显著增加,从72%增加到93% (p=0.026).
- 在二次结果中观察到改善,包括母乳养率和第一次养的时间.
- 没有注意到死性肠球炎发病率的增加,这表明该方案的安全性.
结论:
- 通过跨学科合作开发的标准化,基于证据的养方案,有效地增加了患有冠状动脉疾病的新生儿的手术前肠道养率.
- 该倡议证明了在IV级重症监护托儿所成功实施和维持改善的养实践.
- 这项质量改进项目强调了结构化协议在管理复杂儿科疾病中的重要性.
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