Nguyen Linda T, Cooperberg David B, Spear Michael L
Pediatrics, Drexel University of Medicine, St. Christopher's Hospital for Children, Philadelphia, PA, USA.
J Perinatol. 2018 May;38(5):574-579. doi: 10.1038/s41372-018-0067-1. Epub 2018 May 8.
We sought to explore the beliefs regarding palliative care team utilization, as well as increase consultation and awareness of the palliative care team's role in the NICU.
The study design in this Level 4 NICU included observational time series with multiple planned sequential interventions. Medical chart review was conducted to determine eligibility, and statistical process control charts were used to show performance over time.
Prior to implementation of the triggers, 26% received consultation, which increased to 46% after implementation. There was an increase in level of understanding, knowledge of team's role, and improved utilization. The time until initial consultation decreased from ~1.5 months to 1 week.
We observed a 20% increase in consultations. Key interventions included continual education, reminders, and clear postage of the trigger list. Written guidelines increase awareness of a palliative care team's role within a NICU, and provider satisfaction.
我们试图探索关于姑息治疗团队使用的观念，同时提高对姑息治疗团队在新生儿重症监护病房（NICU）中作用的会诊率和认知度。
这项在四级新生儿重症监护病房进行的研究设计包括带有多个计划好的序贯干预措施的观察性时间序列研究。通过病历审查来确定入选资格，并使用统计过程控制图来展示随时间推移的表现。
在实施触发因素之前，26%的患者接受了会诊，实施后这一比例增至46%。对姑息治疗团队作用的理解程度、相关知识以及利用率均有所提高。首次会诊的时间从约1.5个月缩短至1周。
我们观察到会诊率提高了20%。关键干预措施包括持续教育、提醒以及明确张贴触发因素清单。书面指南提高了对姑息治疗团队在新生儿重症监护病房中作用的认知度以及医护人员的满意度。
