Department of General Surgery, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
BMJ Open Qual. 2023 Aug;12(3). doi: 10.1136/bmjoq-2023-002396.
This project aimed to address the issue of patients experiencing prolonged fasting periods before undergoing abdominal ultrasound scans in a busy surgical service at our hospital. A review of in-patient data revealed that 78% of patients were not following the recommended 6 hours fast before the scan. This led to poor patient experiences, prolonged diagnosis and management, and increased costs due to rescheduling of scans. To address this problem, a series of plan-do-study-act (PDSA) cycles were implemented to test different interventions aimed at improving staff awareness and compliance with fasting guidelines. The first PDSA cycle involved displaying a poster with fasting instructions in the doctors and nursing offices. This was followed by increasing awareness of guidelines during meetings and presenting the findings at a teaching session. Each PDSA cycle was followed by data collection to assess the impact of the intervention. The project resulted in an improvement in patient experiences, with 88% of patients being appropriately fasted by the end of the project. The study highlights the importance of using PDSA cycles to test and refine interventions and the positive impact of simple interventions on patient outcomes and clinical workflow.
本项目旨在解决我院繁忙外科手术服务中患者在接受腹部超声检查前长时间禁食的问题。对住院患者数据的审查显示,78%的患者在扫描前未遵循建议的 6 小时禁食。这导致患者体验不佳、诊断和管理时间延长,并且由于扫描重新安排而增加成本。为了解决这个问题,我们实施了一系列计划-执行-研究-行动(PDSA)循环,以测试旨在提高员工对禁食指南的认识和遵守的不同干预措施。第一个 PDSA 循环涉及在医生和护理办公室张贴带有禁食说明的海报。随后,我们在会议上提高了对指南的认识,并在教学会议上介绍了研究结果。每个 PDSA 循环之后都会收集数据,以评估干预措施的影响。该项目改善了患者的体验,到项目结束时,88%的患者得到了适当的禁食。该研究强调了使用 PDSA 循环测试和改进干预措施的重要性,以及简单干预对患者结局和临床工作流程的积极影响。