新生儿重症监护病房的死亡率：提高死亡报告的准确性。
Mortality in the neonatal intensive care unit: improving the accuracy of death reporting.
机构信息
Division of Genetics and Genomics, Boston, MA, USA.
Division of Newborn Medicine, Boston, MA, USA.
出版信息
J Perinatol. 2022 May;42(5):671-676. doi: 10.1038/s41372-021-01214-3. Epub 2021 Sep 28.
OBJECTIVE
Death certificates commonly contain errors, which hinders understanding of infant mortality. We, therefore, undertook a quality improvement (QI) initiative to improve death reporting in our neonatal intensive care unit (NICU).
STUDY DESIGN
After our baseline assessment (January 1, 2015 to June 30, 2017), we implemented our QI initiatives using Plan, Do, Study, Act (PDSA) tests of change. We prospectively reviewed death certificates (July 1, 2017 to December 31, 2019) to evaluate the impact of our interventions.
RESULTS
The overall proportion of incorrect death certificates significantly decreased from 71 to 22% with special cause variation noted after the second PDSA cycle. The most common errors involved inaccurate or incomplete reporting of prematurity and errors in the sequence of events.
CONCLUSION
Through a series of PDSA cycles focused on formal provider education and ongoing review, we significantly reduced inaccurate death reporting. These interventions are generalizable across NICUs and important to improve public health reporting accuracy.
目的
死亡证明中常存在错误，这阻碍了对婴儿死亡率的理解。因此，我们开展了一项质量改进（QI）计划，以改进我们新生儿重症监护病房（NICU）的死亡报告。
研究设计
在基线评估（2015 年 1 月 1 日至 2017 年 6 月 30 日）之后，我们使用计划-执行-研究-行动（PDSA）变更测试实施了我们的 QI 计划。我们前瞻性地审查了死亡证明（2017 年 7 月 1 日至 2019 年 12 月 31 日），以评估干预措施的影响。
结果
不正确的死亡证明的总体比例从 71%显著下降到 22%，在第二次 PDSA 循环后注意到特殊原因的变化。最常见的错误涉及早产儿的不准确或不完整报告以及事件顺序中的错误。
结论
通过一系列专注于正式提供教育和持续审查的 PDSA 循环，我们显著减少了不准确的死亡报告。这些干预措施在 NICU 中具有普遍性，对于提高公共卫生报告的准确性很重要。
Zotero 插件