提高急诊科脓毒症患者的抗生素使用比例。

Improving Antibiotic Administration Rate for Patients With Sepsis in the Emergency Department.

机构信息

Intensive Care Unit, Tsukuba University of Hospital, Tsukuba, Ibaraki, Japan (Mss Hatozaki and Okamoto and Mr Nakajima); Ibaraki Christian University, Hitachi, Ibaraki, Japan (Dr Sakuramoto); and Department of Emergency and Critical Care Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan (Drs Shimojo and Inoue).

出版信息

J Nurs Care Qual. 2021;36(4):322-326. doi: 10.1097/NCQ.0000000000000540.

DOI:10.1097/NCQ.0000000000000540

PMID:33416264

Abstract

BACKGROUND

Previous studies have demonstrated that delayed antibiotic administration increases the risk of mortality in patients with sepsis.

LOCAL PROBLEM

In the emergency department, the antibiotic administration rate within 1 and 3 hours for patients with suspected sepsis was low.

METHODS/INTERVENTIONS: We implemented an educational intervention with the nursing staff, which included training sessions and feedback, to ensure early detection and management of patients with suspected sepsis. Antibiotic administration rates were compared before and after education.

RESULTS

A total of 503 patients were included. The antibiotic administration rate improved as the phases continued (1 hour: from 5.2% to 15.6%, P = .004; 3 hours: from 35.6% to 49.7%, P = .04; 6 hours: from 74.1% to 89.1%, P = .002). The time to initial antibiotic administration also improved from 229 to 185 minutes (P < .001).

CONCLUSIONS

Nurse-initiated quality improvement improved the early administration of antibiotics for patients with suspected sepsis.

摘要

背景

先前的研究表明，延迟使用抗生素会增加脓毒症患者的死亡风险。

当地问题

在急诊科，疑似脓毒症患者在 1 小时和 3 小时内使用抗生素的比例较低。

方法/干预措施：我们对护理人员实施了一项教育干预措施，包括培训课程和反馈，以确保早期发现和管理疑似脓毒症患者。比较了教育前后的抗生素使用情况。

结果

共纳入 503 例患者。随着阶段的推进，抗生素的使用比例有所提高（1 小时：从 5.2%升至 15.6%，P =.004；3 小时：从 35.6%升至 49.7%，P =.04；6 小时：从 74.1%升至 89.1%，P =.002）。初始抗生素治疗的时间也从 229 分钟缩短至 185 分钟（P <.001）。