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降低剖宫产患者阿片类药物使用量的质量改进项目

Quality Improvement Project to Reduce Opioid Use in Patients Undergoing Cesarean Birth.

作者信息

Eldridge Ta'Tanisha, Martin Nolan, Campbell Lisa, Song Huaxin, Frazier Linda

出版信息

AORN J. 2022 Apr;115(4):327-336. doi: 10.1002/aorn.13646.

Abstract

After observing the effectiveness of Enhanced Recovery After Surgery (ERAS) protocols for gynecological surgery patients, an interdisciplinary team initiated a quality improvement project with an ERAS protocol to minimize opioid use of patients undergoing elective cesarean birth. Secondary outcomes during the three-month project included decreasing the patient's length of stay and inpatient care costs. We used the Lean Six Sigma methodology and measured aggregated patient outcomes of opioid use, length of hospital stay, and total cost. In addition, we incorporated the ERAS protocol into the electronic health record. Results showed a reduction use of morphine milligram equivalents of opioids, a slight decrease in length of hospital stay, and no change in the inpatient costs. The team recognized that implementation of an ERAS protocol is a best practice to reduce opioid use in patients undergoing a cesarean birth and decided to permanently include it in patient care processes.

摘要

在观察到术后加速康复(ERAS)方案对妇科手术患者的有效性后,一个跨学科团队启动了一个质量改进项目,采用ERAS方案以尽量减少择期剖宫产患者的阿片类药物使用。该为期三个月的项目的次要结果包括缩短患者住院时间和降低住院护理成本。我们采用了精益六西格玛方法,并对阿片类药物使用、住院时间和总成本等汇总的患者结果进行了测量。此外,我们将ERAS方案纳入了电子健康记录。结果显示,阿片类药物的吗啡毫克当量使用量减少,住院时间略有缩短,住院费用没有变化。该团队认识到实施ERAS方案是减少剖宫产患者阿片类药物使用的最佳做法,并决定将其永久纳入患者护理流程。

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