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评估并开发可能更好的做法,以改善新生儿重症监护病房的出院流程。

Evaluation and development of potentially better practices to improve the discharge process in the neonatal intensive care unit.

作者信息

Sims Debra C, Jacob Jack, Mills Marla M, Fett Patricia A, Novak Gayle

机构信息

Newborn Intensive Care Unit, The Children's Hospital at Providence, 3200 Providence Dr, PO Box 196604, Anchorage, AK 99519-6604, USA.

出版信息

Pediatrics. 2006 Nov;118 Suppl 2:S115-23. doi: 10.1542/peds.2006-0913H.

Abstract

OBJECTIVE

Our goal was to identify potentially better practices that create a successful discharge planning process that spans the entire newborn intensive care stay to the next level of care by embedding the discharge planning into all aspects of patient care and communication.

METHODS

Potentially better practices were developed through recommendations from a content expert and a literature review. Internal benchmarking, self-assessment tools, monthly conference calls, the Neonatal Intensive Care Quality Improvement Collaborative 2002 listserv, parent feedback, and semiannual conferences were used to finalize recommendations and implement practices.

RESULTS

Potentially better practices included (1) create an easy-to-use/easy-to-access discharge planning tool kit, (2) restructure written and oral communication tools and processes to reflect plans for the day, the stay, and the way to discharge, (3) maximize the impact and use of caregiver educational tools, and update materials and delivery systems for caregiver education, (4) use continuous quality improvement tools and processes to ensure parent/caregiver and staff satisfaction, and (5) analyze and enhance transfers into and interactions with the community.

CONCLUSION

The potentially better practices are recommendations that are designed to integrate organizational, clinical, and operational processes to ensure optimal discharge planning from admission through follow-up in the community.

摘要

目的

我们的目标是确定可能更好的做法,通过将出院计划融入患者护理和沟通的各个方面,打造一个成功的出院计划流程,该流程贯穿新生儿重症监护的全过程直至下一护理阶段。

方法

通过内容专家的建议和文献综述制定可能更好的做法。利用内部基准评估、自我评估工具、月度电话会议、2002年新生儿重症监护质量改进协作组织邮件列表、家长反馈以及半年一次的会议来确定建议并实施相关做法。

结果

可能更好的做法包括:(1)创建一个易于使用/易于获取的出院计划工具包;(2)重新构建书面和口头沟通工具及流程,以反映当日、住院期间及出院方式的计划;(3)最大限度地发挥护理人员教育工具的作用并加以利用,更新护理人员教育的材料和交付系统;(4)使用持续质量改进工具和流程来确保家长/护理人员及工作人员的满意度;(5)分析并加强转入社区及与社区的互动。

结论

这些可能更好的做法是旨在整合组织、临床和运营流程的建议,以确保从入院到社区随访的最佳出院计划。

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