University of Michigan, Ann Arbor, MI 48109, USA.
J Nurs Adm. 2010 Oct;40(10):417-23. doi: 10.1097/NNA.0b013e3181f2eb5b.
The inclusion of the failure to rescue (FTR) measure as one of the Centers for Medicare and Medicaid Services Inpatient Prospective Payment System measures has raised questions about the characteristics of FTR cases and their outcomes. In this study, we validated 75% of the identified FTR complications using medical record review (n = 461). Nearly half (49.5%) of the complications originated in the community and were present on admission. Acute renal failure, gastrointestinal hemorrhage, and sepsis most often originated in the community. Cardiac arrest/shock, pneumonia, and pulmonary embolism and deep vein thrombosis most often developed in the hospitals. These findings have important implications for practice as clinical leadership focuses on the prevention and aggressive management of complications to prevent death, increased length of stay, and possible reductions in Medicare diagnosis related groups' reimbursements.
纳入救援失败（FTR）作为医疗保险和医疗补助服务机构住院患者预付费制度措施之一，引发了人们对 FTR 病例特征及其结果的疑问。在这项研究中，我们使用病历审查验证了 75%已识别的 FTR 并发症（n=461）。几乎一半（49.5%）的并发症源自社区且是入院时就存在的。急性肾衰竭、胃肠道出血和败血症最常源自社区。心脏骤停/休克、肺炎和肺栓塞以及深静脉血栓形成最常发生在医院。这些发现对实践具有重要意义，因为临床领导层专注于预防和积极管理并发症，以防止死亡、住院时间延长以及医疗保险诊断相关组报销的可能减少。
