改善重症监护中患者日记的使用：一份质量改进报告。
Improving patient diary use in intensive care: A quality improvement report.
作者信息
Veloso Costa Asya, Padfield Olivia, Elliott Sarah, Hayden Paul
机构信息
GKT School of Medical Education, King's College London, London, UK.
Physiotherapy, Medway NHS Foundation Trust, Kent, UK.
出版信息
J Intensive Care Soc. 2021 Feb;22(1):27-33. doi: 10.1177/1751143719885295. Epub 2019 Oct 28.
BACKGROUND
Patients surviving critical illness are at risk of developing psychological symptoms that affect quality of life and recovery. Patient diaries may improve psychological outcomes by reducing gaps in memory and contextualising what has happened during admission. Factors including lack of guidelines, lack of awareness and time constraints may lead to poor diary use.
AIMS
This quality improvement project aimed to increase diary provision and overall multidisciplinary team engagement with diaries for all patients admitted for over 72 h to an intensive care unit.
METHODS
Trialled changes implemented via the 'Plan-Do-Study-Act' method included adding alerts to the online patient note system, providing education sessions and introducing a guidance document to facilitate entry completion.
RESULTS
A 'diary provision' target of 100% was achieved (from a baseline of 26.1%). Simple changes have proven effective in establishing routine engagement with diaries, and lessons may be used to improve diary systems elsewhere.
背景
危重症幸存者有出现影响生活质量和康复的心理症状的风险。患者日记可通过减少记忆空白和将住院期间发生的事情情境化来改善心理结局。包括缺乏指南、缺乏认识和时间限制等因素可能导致日记使用不佳。
目的
这个质量改进项目旨在增加日记的提供，并提高多学科团队对所有入住重症监护病房超过72小时的患者使用日记的整体参与度。
方法
通过“计划-实施-研究-改进”方法试行的改变包括在在线患者记录系统中添加提醒、举办教育课程以及引入一份指导文件以促进日记填写的完成。
结果
实现了100%的“日记提供”目标（从26.1%的基线水平）。简单的改变已证明在建立使用日记的常规流程方面是有效的，相关经验教训可用于改善其他地方的日记系统。
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