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建立基于医院的创伤登记系统:肯尼亚的经验教训。

Establishing hospital-based trauma registry systems: lessons from Kenya.

机构信息

Johns Hopkins International Injury Research Unit, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD 21205, USA; Department of Surgery, Johns Hopkins Hospital, 720 Rutland Ave, Baltimore, MD 21205, USA.

Johns Hopkins International Injury Research Unit, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD 21205, USA.

出版信息

Injury. 2013 Dec;44 Suppl 4:S70-4. doi: 10.1016/S0020-1383(13)70216-X.

Abstract

OBJECTIVE

In the developing world, data about the burden of injury, injury outcomes, and complications of care are limited. Hospital-based trauma registries are a data source that can help define this burden. Under the trauma care component of the Bloomberg Global Road Safety Partnership, trauma registries have been implemented at three sites in Kenya. We describe the challenges and lessons learned from this effort.

METHODS

A paper-based trauma surveillance form was developed, in collaboration with local hospital partners, to collect data on all trauma patients presenting for care. The form includes demographic information, pre-hospital care given, and patient care and clinical information necessary to calculate estimated injury surveillance. The type of data collected was standardized across all three sites. Frequent reviews of the data collection process, quality, and completeness, in addition to regular meetings and conference calls, have allowed us to optimize the process to improve efficiency and make corrective actions where required.

RESULTS

Trauma registries have been implemented in three hospitals in Kenya, with potential for expansion to other hospitals and facilities caring for injured patients. The process of establishing registries was associated with both general and site-specific challenges. Problems were identified in planning, data collection, entry processes, and analysis. Problems were addressed when identified, resulting in improved data quality.

CONCLUSIONS

Trauma registries are a key data source for defining the burden of injury and developing quality improvement processes. Trauma registries were implemented at three sites in Kenya. Problems and challenges in data collection were identified and corrected. Through the registry data, gaps in care were identified and systemic changes made to improve the care of the injured.

摘要

目的

在发展中国家,有关伤害负担、伤害结局和治疗并发症的数据十分有限。基于医院的创伤登记处是一种可以帮助确定这一负担的数据来源。在彭博全球道路安全合作伙伴关系的创伤护理部分下,肯尼亚的三个地点已经实施了创伤登记处。我们描述了从这一努力中获得的挑战和经验教训。

方法

与当地医院合作伙伴合作,开发了纸质创伤监测表,以收集所有因受伤寻求治疗的患者的数据。该表包括人口统计学信息、院前护理和计算估计伤害监测所需的患者护理和临床信息。在所有三个地点,都对收集的数据类型进行了标准化。除了定期会议和电话会议外,还经常对数据收集过程、质量和完整性进行审查,这使我们能够优化流程,提高效率,并在需要时采取纠正措施。

结果

肯尼亚的三家医院已经实施了创伤登记处,有可能扩展到其他医院和为受伤患者提供服务的设施。建立登记处的过程涉及一般和特定地点的挑战。在规划、数据收集、输入过程和分析中发现了问题。在发现问题时,会对其进行处理,从而提高数据质量。

结论

创伤登记处是确定伤害负担和制定质量改进流程的关键数据来源。肯尼亚的三个地点已经实施了创伤登记处。在数据收集方面发现并纠正了问题和挑战。通过登记处的数据,确定了护理中的差距,并进行了系统性的改变,以改善对伤者的护理。

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