一项旨在减少新生儿重症监护病房吸入治疗过度使用的质量改进举措。
A quality improvement initiative to reduce excess inhaled therapy use in the neonatal intensive care unit.
作者信息
Zierk Avery, Gumbel Mary Jo, Mackenzie Rachel, Matthews Kelle, Simmons Francis, Bustin Anna, DeFelice Christina, Morris Heidi, Soorikian Leane, Swartz Kimberly, Nickel Amanda, Gibbs Kathleen
机构信息
Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Center for Healthcare Quality and Analytics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
出版信息
J Perinatol. 2024 Oct 3. doi: 10.1038/s41372-024-02132-w.
OBJECTIVE
Inhaled medications are commonly used at our single-center, Level IV neonatal intensive care unit (NICU). We lacked a standardized process for measuring efficacy of these medications to guide optimal duration of use, potentially leading to their overuse.
METHODS
We utilized quality improvement methodology to reduce the length of inhaled hypertonic saline (HTS) course durations and high frequency albuterol use. Interventions included education, data sharing, and implementation of a respiratory therapy assessment tool.
RESULTS
The average inhaled HTS course duration decreased from 8.7 to 4.2 days. The percentage of q4 albuterol administrations per total albuterol doses administered monthly decreased from 39 to 20%.
CONCLUSION
Developing a shared mental model between interprofessional providers for the indication and effect of inhaled agents and standardizing assessment of these medications' efficacy can reduce their overuse.
目的
在我们的单中心四级新生儿重症监护病房（NICU），吸入药物被广泛使用。我们缺乏一个标准化的流程来衡量这些药物的疗效，以指导最佳使用时长，这可能导致药物的过度使用。
方法
我们采用质量改进方法来缩短吸入性高渗盐水（HTS）疗程时长，并减少沙丁胺醇的高频使用。干预措施包括教育、数据共享以及实施呼吸治疗评估工具。
结果
吸入性HTS的平均疗程时长从8.7天降至4.2天。每月沙丁胺醇总给药剂量中每4小时给药一次的百分比从39%降至20%。
结论
在跨专业医疗服务提供者之间建立关于吸入药物的适应症和效果的共同思维模式，并对这些药物的疗效评估进行标准化，可以减少其过度使用。
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