改善胫骨应力性骨折的管理：一项基于门诊诊所的合作性质量改进项目。
Improving the management of tibia stress fractures: a collaborative, outpatient clinic-based quality improvement project.
作者信息
Roberts Cindy L, Meyering Christopher D, Zychowicz Michael E
机构信息
Cindy L. Roberts, Major, DNP, RN, FNP-C, MBA, Clinical Research Nurse Practitioner, Department of Warrior Care, Martin Army Community Hospital, Fort Benning, GA. Christopher D. Meyering, Lt. Colonel, DO, Director, Sports Medicine, Family Medicine Residency Program, Dwight D. Eisenhower Army Medical Center, Fort Gordon, GA. Michael E. Zychowicz, DNP, RN, ANP, ONP, FAAN, FAANP, Director, MSN Program and Orthopaedic Program Lead Faculty, Duke University, Durham, NC.
出版信息
Orthop Nurs. 2014 Mar-Apr;33(2):75-83; quiz 84-5. doi: 10.1097/NOR.0000000000000032.
PURPOSE
Implement and evaluate the effectiveness of the Leg Pain Screening and Referral Tool (LPS&RT) for patients presenting with lower extremity leg pain in an outpatient clinic.
SAMPLE
A total of 46 patients diagnosed with tibia stress fractures.
METHODS
The study employed a pre-/postintervention design. Retrospective and prospective information was collected from an electronic health record to obtain patient data. The pre- and postintervention groups were compared on the number of patients diagnosed with tibia stress fractures. Provider adherence to the treatments recommended by the algorithm was assessed by chart audits postintervention.
RESULTS
There was a significant increase (87.5%) in tibia stress fracture diagnosis, from 16 preintervention to 30 postintervention. Provider adherence to the LPS&RT was 93.3% postintervention. Common treatments were activity restriction, oral medication, and/or specialty referrals.
CONCLUSION
The LPS&RT was an effective, uniform measure to standardize the plan of care for tibia stress fractures in one outpatient clinic.
目的
在门诊诊所中，实施并评估腿部疼痛筛查与转诊工具（LPS&RT）对出现下肢腿部疼痛患者的有效性。
样本
共有46例被诊断为胫骨应力性骨折的患者。
方法
本研究采用干预前/后设计。从电子健康记录中收集回顾性和前瞻性信息以获取患者数据。比较干预前和干预后被诊断为胫骨应力性骨折的患者数量。干预后通过图表审核评估医疗服务提供者对算法推荐治疗方法的依从性。
结果
胫骨应力性骨折的诊断有显著增加（87.5%），从干预前的16例增加到干预后的30例。干预后医疗服务提供者对LPS&RT的依从性为93.3%。常见的治疗方法是活动限制、口服药物和/或专科转诊。
结论
LPS&RT是一种有效的、统一的措施，可规范一家门诊诊所中胫骨应力性骨折的护理计划。
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