James Matthew T, Pannu Neesh
Department of Medicine and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada.
Nephron. 2015;131(4):237-41. doi: 10.1159/000441426. Epub 2015 Nov 11.
Quality indicators are measurements of healthcare outcome, process, or structure that can be used as tools to measure the quality of care and identify opportunities for improvement. Acute kidney injury (AKI) has many characteristics that make it a potential target for quality indicator development. It is common, associated with a high risk of adverse outcomes, and there are reports of gaps in the quality of care in several clinical settings despite publication of evidence-based guidelines. Substantial work has already been undertaken to develop quality measures related to AKI following percutaneous coronary interventions and major surgical procedures. This paper reviews the current literature that has addressed issues of prevention or management of AKI as outcome, process, or structure quality indicators in these clinical settings. Several current controversies about the appropriateness of such indicators related to AKI are identified. Further research to strengthen the evidence-base supporting prevention and management initiatives for AKI across all relevant clinical settings is needed to clarify the role of AKI as a target for clinical quality indicators.
质量指标是对医疗保健结果、过程或结构的衡量，可用作衡量医疗质量和识别改进机会的工具。急性肾损伤（AKI）具有许多特征，使其成为质量指标开发的潜在目标。它很常见，与不良后果的高风险相关，并且尽管发布了循证指南，但仍有报告称在一些临床环境中存在护理质量差距。在经皮冠状动脉介入治疗和大手术后，已经开展了大量工作来制定与AKI相关的质量措施。本文回顾了当前将AKI的预防或管理问题作为这些临床环境中的结果、过程或结构质量指标的文献。确定了目前有关此类与AKI相关指标适当性的几个争议点。需要进一步研究以加强支持所有相关临床环境中AKI预防和管理举措的证据基础，以阐明AKI作为临床质量指标目标的作用。
