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巴西圣保罗阿尔伯特·爱因斯坦以色列医院实施出血代码(代码H)后的出血管理

Bleeding management after implementation of the Hemorrhage Code (Code H) at the Hospital Israelita Albert Einstein, São Paulo, Brazil.

作者信息

Jaures Michele, Pigatti Neila Maria Marques Negrini, Rodrigues Roseny Dos Reis, Fernandes Fernanda Paulino, Guerra João Carlos de Campos

机构信息

Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.

出版信息

Einstein (Sao Paulo). 2020;18:eAO5032. doi: 10.31744/einstein_journal/2020ao5032. Epub 2020 Aug 28.

Abstract

Objective To describe the implementation of a care protocol based on rapid response teams, for management and resolution of bleeding. Methods A hospital protocol called Hemorrhage Code (Code H) was devised and developed. In a flow line, a multidisciplinary team provides comprehensive, fast and effective care to the patient with a severe hemorrhagic condition. In another flow line, professionals based at the hospital pharmacy focus on identifying patients at risk of bleeding, to avoid this event. Several hospital professionals and sectors were trained, each with specific roles, ensuring full support to the medical and nursing staffs. Results After implementing this protocol, we were able to significantly reduce the number of catastrophic events related to failure in bleeding management. Conclusion Code H is an example of a value-based medicine and precision medicine project by delivering comprehensive and multidisciplinary care, in addition to point-of-care testing introduced in clinical practice, optimizing patient safety and care practices at the hospital. Furthermore, it will be possible to minimize the risk of lawsuits for the hospital and physicians, as well as rationalizing resources with benefits for administrators and payers.

摘要

目的 描述基于快速反应团队的护理方案在出血管理与解决中的实施情况。方法 设计并制定了一项名为“出血代码(代码H)”的医院方案。在一条流程线上,多学科团队为患有严重出血状况的患者提供全面、快速且有效的护理。在另一条流程线上,医院药房的专业人员专注于识别出血风险患者,以避免此类事件发生。对医院的多名专业人员和多个部门进行了培训,每个人员和部门都有特定职责,确保为医护人员提供全力支持。结果 实施该方案后,我们能够显著减少与出血管理失败相关的灾难性事件数量。结论 代码H是基于价值的医学和精准医学项目的一个范例,它通过提供全面的多学科护理,以及在临床实践中引入即时检验,优化了医院的患者安全和护理实践。此外,还能够将医院和医生面临诉讼的风险降至最低,同时使资源合理化,为管理人员和付款人带来益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4561/9586425/a8e32999b976/2317-6385-eins-18-eAO5032-gf01.jpg

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