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新生儿重症监护病房出院后的家庭护理和医疗保健利用错误

Homecare and Healthcare Utilization Errors Post-Neonatal Intensive Care Unit Discharge.

作者信息

Patel Rupalee, Nudelman Matthew, Olarewaju Adebola, Pooley Sunshine Weiss, Jegatheesan Priya, Song Dongli, Govindaswami Balaji

机构信息

Santa Clara Valley Health and Hospital System, San Jose, California.

出版信息

Adv Neonatal Care. 2017 Aug;17(4):258-264. doi: 10.1097/ANC.0000000000000390.

Abstract

BACKGROUND

High-risk infants transitioning from the neonatal intensive care unit (NICU) to home represent a vulnerable population, given their complex care requirements. Little is known about errors during this period.

PURPOSE

Identify and describe homecare and healthcare utilization errors in high-risk infants following NICU discharge.

METHODS

This was a prospective observational cohort study of homecare (feeding, medication, and equipment) and healthcare utilization (appointment) errors in infants discharged from a regional NICU between 2011 and 2015. Chi-square test and Wilcoxon rank-sum test were used to compare infant and maternal demographics between infants with and without errors.

RESULTS

A total of 363 errors were identified in 241 infants during 635 home visits. The median number of visits was 2. No significance was found between infant and maternal demographics in those with or without errors.

IMPLICATIONS OF PRACTICE

High-risk infants have complex care needs and can benefit from regular follow-up services. Home visits provide an opportunity to identify, intervene, and resolve homecare and healthcare utilization errors.

IMPLICATIONS OF RESEARCH

Further research is needed to evaluate the prevalence and cause of homecare errors in high-risk infants and how healthcare resources and infant health outcomes are affected by those errors. Preventive measures and mitigating interventions that best address homecare errors require further development and subsequent description.

摘要

背景

鉴于其复杂的护理需求,从新生儿重症监护病房(NICU)过渡到家庭的高危婴儿是一个弱势群体。关于这一时期的差错情况,人们了解甚少。

目的

识别并描述高危婴儿在NICU出院后的家庭护理及医疗服务利用方面的差错。

方法

这是一项前瞻性观察队列研究,研究对象为2011年至2015年间从某地区NICU出院的婴儿的家庭护理(喂养、用药及设备)和医疗服务利用(预约)差错情况。采用卡方检验和Wilcoxon秩和检验比较有差错和无差错婴儿的婴儿及母亲人口统计学特征。

结果

在635次家访期间,共在241名婴儿中发现363处差错。家访次数中位数为2次。有差错和无差错婴儿的婴儿及母亲人口统计学特征之间未发现显著差异。

实践意义

高危婴儿有复杂的护理需求,可从定期随访服务中受益。家访为识别、干预和解决家庭护理及医疗服务利用差错提供了机会。

研究意义

需要进一步研究以评估高危婴儿家庭护理差错的发生率和原因,以及这些差错如何影响医疗资源和婴儿健康结局。最能解决家庭护理差错的预防措施和缓解干预措施需要进一步制定和后续描述。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0b8b/5533584/b44018abd0a1/ancr-17-258-g001.jpg

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