Bayliss Yvette, Jensen Katherine
Tom Baker Cancer Centre, Calgary, Alberta, Canada.
Tom Baker Cancer Centre, Calgary, Alberta, Canada.
J Med Imaging Radiat Sci. 2011 Jun;42(2):74-80. doi: 10.1016/j.jmir.2011.01.001. Epub 2011 May 30.
An extensive literature review was completed to validate the selection of quality indicators for venipuncture procedures performed in a radiation therapy department.
A retrospective quantitative study (2007-2010) was conducted at the Tom Baker Cancer Center (TBCC) to review the data captured on a quality control log/statistical template for 900 venipuncture procedures performed in the radiation treatment program (RTP). The quality indicators for the venipuncture program had previously been identified to include the collection and monitoring of: the frequency/occurrence of adverse events, identifying the type of adverse events, and the number of attempts required to obtain venous access. There were no patient identifiers recorded on the department log/statistical template.
Data extracted from the TBCC RTP quality control log in 2007-2010 revealed an incidence of five extravasations events and one air embolism event. Comparison of the published adverse events and rates in the literature to the TBCC RTP venipuncture program rates show that its recorded quality control log/statistical template is targeting the appropriate categories. The literature reported, on average, rates for extravasations to be between 0.04% and 1.3% compared with the TBCC RT department's 0.56%. The occurrence of air embolism rates in the literature was reported to be between 11.7% and 23% compared with 0.11% occurrence in the TBCC RTP department. Based on the evidence reported in the literature, other quality control indicators have been incorporated into the TBCC RTP venipuncture program. The TBCC RTP expanded the venipuncture program quality control log/statistical template to collect and monitor the occurrence rates of phlebitis, hematoma/bruising, nerve, tendon and/or ligament damage, and infection.
The creation of standardized quality indicators for radiation treatment programs performing venipuncture in all health care facilities performing venipuncture would 1) be a step in maximizing patient safety and improving quality of care and 2) provide an opportunity for institutions to gauge and compare the quality of care provided using the same quality indicators for health care institutes performing venipuncture procedures. Collaboration with other facilities to identify, monitor, and report the data collected from standardized quality indicators would result in an increase of knowledge concerning the occurrence of rates of adverse events during and after venipuncture procedures performed in a radiation therapy department. Such efforts can only lead to increased quality of care provided across the health care system.
完成一项广泛的文献综述，以验证放射治疗科静脉穿刺操作质量指标的选择。
在汤姆·贝克癌症中心（TBCC）进行了一项回顾性定量研究（2007 - 2010年），以审查在放射治疗项目（RTP）中进行的900次静脉穿刺操作的质量控制日志/统计模板上记录的数据。静脉穿刺项目的质量指标先前已确定包括收集和监测：不良事件的频率/发生率、识别不良事件的类型以及获得静脉通路所需的尝试次数。科室日志/统计模板上未记录患者标识符。
从2007 - 2010年TBCC RTP质量控制日志中提取的数据显示有5例渗漏事件和1例空气栓塞事件。将文献中公布的不良事件及发生率与TBCC RTP静脉穿刺项目的发生率进行比较，结果表明其记录的质量控制日志/统计模板针对的是适当的类别。文献报道，渗漏发生率平均在0.04%至1.3%之间，而TBCC放疗科为0.56%。文献中报道的空气栓塞发生率在11.7%至23%之间，而TBCC RTP科室为0.11%。基于文献报道的证据，其他质量控制指标已纳入TBCC RTP静脉穿刺项目。TBCC RTP扩展了静脉穿刺项目质量控制日志/统计模板，以收集和监测静脉炎、血肿/瘀伤、神经、肌腱和/或韧带损伤以及感染的发生率。
为所有进行静脉穿刺的医疗机构中的放射治疗项目制定标准化质量指标，将：1）是朝着最大限度提高患者安全性和改善护理质量迈出的一步；2）为各机构提供一个机会，以使用相同的质量指标来衡量和比较进行静脉穿刺操作的医疗机构所提供的护理质量。与其他机构合作，识别、监测和报告从标准化质量指标收集的数据，将增加有关放射治疗科静脉穿刺操作期间及之后不良事件发生率的知识。这些努力只会提高整个医疗系统所提供的护理质量。
