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患者就诊流程审核工具(PJAT),用于评估核医学服务中的质量指标。

A patient journey audit tool (PJAT) to assess quality indicators in a nuclear medicine service.

机构信息

Department of Molecular Imaging and Therapy, Austin Health, Level 1, Harold Stokes Building, Studley Road, Melbourne, Victoria, 3084, Australia.

Olivia Newton-John Cancer Research Institute, Melbourne, Victoria, Australia.

出版信息

Eur J Nucl Med Mol Imaging. 2024 Jun;51(7):1816-1825. doi: 10.1007/s00259-024-06627-8. Epub 2024 Feb 10.

Abstract

PURPOSE

To develop a nuclear medicine specific patient journey audit tool (PJAT) to survey and audit patient journeys in a nuclear medicine department such as staff interaction with patients, equipment, quality of imaging and laboratory procedures, patient protection, infection control and radiation safety, with a view to optimising patient care and providing a high-quality nuclear medicine service.

METHODS

The PJAT was developed specifically for use in nuclear medicine practices. Thirty-two questions were formulated in the PJAT to test the department's compliance to the Australian National Safety and Quality Health Service Standards, namely clinical governance, partnering with consumers, preventing and controlling health care infection, medication safety, comprehensive care, communicating for safety, blood management and recognising and responding to acute deterioration. The PJAT was also designed to test our department's adherence to diagnostic reference levels (DRL). A total of 60 patient journey audits were completed for patients presenting for nuclear medicine, positron emission tomography and bone mineral density procedures during a consecutive 4-week period to audit the range of procedures performed. A further 120 audits were captured for common procedures in nuclear medicine and positron emission tomography during the same period. Thus, a total of 180 audits were completed. A subset of 12 patients who presented for blood labelling procedures were audited to solely assess the blood management standard.

RESULTS

The audits demonstrated over 85% compliance for the Australian national health standards. One hundred percent compliance was noted for critical aspects such as correct patient identification for the correct procedure prior to radiopharmaceutical administration, adherence to prescribed dose limits and distribution of the report within 24 h of completion of the imaging procedure.

CONCLUSION

This PJAT can be applied in nuclear medicine departments to enhance quality programmes and patient care. Austin Health has collaborated with the IAEA to formulate the IAEA PJAT, which is now available globally for nuclear medicine departments to survey patient journeys.

摘要

目的

开发一种核医学专用患者流程审核工具(PJAT),以调查和审核核医学部门的患者流程,如员工与患者的互动、设备、影像和实验室程序的质量、患者保护、感染控制和辐射安全,旨在优化患者护理并提供高质量的核医学服务。

方法

PJAT 是专门为核医学实践开发的。PJAT 中制定了 32 个问题,以测试该部门对澳大利亚国家安全和质量卫生服务标准的遵守情况,即临床治理、与消费者合作、预防和控制医疗感染、药物安全、全面护理、安全沟通、血液管理以及识别和应对急性恶化。PJAT 还旨在测试我们部门对诊断参考水平(DRL)的遵守情况。在连续 4 周的时间里,为接受核医学、正电子发射断层扫描和骨密度程序的患者完成了总共 60 次患者流程审核,以审核所进行的各种程序。在同一时期,还对核医学和正电子发射断层扫描中的常见程序进行了 120 次审核。因此,共完成了 180 次审核。在同一时期,对 12 名接受血液标记程序的患者进行了部分审核,仅评估血液管理标准。

结果

审核结果显示,澳大利亚国家卫生标准的合规率超过 85%。在放射性药物给药前正确识别患者和正确程序、遵守规定的剂量限制以及在成像程序完成后 24 小时内分发报告等关键方面,均达到了 100%的合规率。

结论

这种 PJAT 可用于核医学部门,以增强质量计划和患者护理。奥斯汀健康中心与国际原子能机构合作制定了国际原子能机构 PJAT,现在全球的核医学部门都可以使用该工具来调查患者流程。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90ca/11139729/5149f4276e1d/259_2024_6627_Fig1_HTML.jpg

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