Department of Anesthesiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
Curr Opin Anaesthesiol. 2014 Jun;27(3):323-9. doi: 10.1097/ACO.0000000000000078.
Cognitive aids are tangible or intangible instruments that guide users in decision-making and in the completion of a complex series of tasks. Common examples include mnemonics, checklists, and algorithms. Cognitive aids constitute very effective approaches to achieve well tolerated, high quality healthcare because they promote highly reliable processes that reduce the likelihood of failure. This review describes recent advances in quality improvement for pediatric anesthesiology with emphasis on application of cognitive aids to impact patient safety and outcomes.
Quality improvement encourages the examination of systems to create stable processes and ultimately high-value care. Quality improvement initiatives in pediatric anesthesiology have been shown to improve outcomes and the delivery of efficient and effective care at many institutions. The use of checklists, in particular, improves adherence to evidence-based care in crisis situations, decreases catheter-associated bloodstream infections, reduces blood product utilization, and improves communication during the patient handoff process. Use of this simple tool has been associated with decreased morbidity, fewer medical errors, improved provider satisfaction, and decreased mortality in nonanesthesia disciplines as well.
Successful quality improvement initiatives utilize cognitive aids such as checklists and have been shown to optimize pediatric patient experience and anesthesia outcomes and reduce perioperative complications.
认知辅助工具是指导用户进行决策和完成复杂任务系列的有形或无形工具。常见的例子包括助记符、检查表和算法。认知辅助工具是实现可耐受、高质量医疗保健的非常有效的方法，因为它们促进了高度可靠的流程，降低了失败的可能性。本综述描述了儿科麻醉质量改进的最新进展，重点介绍了认知辅助工具在影响患者安全和结果方面的应用。
质量改进鼓励对系统进行检查，以创建稳定的流程，并最终提供高价值的护理。儿科麻醉学中的质量改进举措已被证明可改善许多机构的结果，并提供高效、有效的护理。检查表的使用，特别是在危机情况下，可提高对循证护理的依从性，减少导管相关血流感染，减少血液制品的使用，并改善患者交接过程中的沟通。这种简单工具的使用与降低发病率、减少医疗错误、提高提供者满意度以及降低非麻醉学科的死亡率有关。
成功的质量改进举措利用认知辅助工具，如检查表，已被证明可优化儿科患者体验和麻醉结果，并减少围手术期并发症。
