Vončina Vanja, Brborović Hana, Brborović Ognjen, Makovšek Alka, Pavičić Šarić Jadranka
Department of Anesthesiology, Intensive Care Medicine and Pain Management, Merkur Clinical Hospital, Zajčeva 19, 10000 Zagreb, Croatia.
School of Medicine, University of Zagreb, Šalata 3, 10000 Zagreb, Croatia.
Healthcare (Basel). 2025 Apr 3;13(7):816. doi: 10.3390/healthcare13070816.
Discharging patients from intensive care units (ICUs) poses significant risks for adverse events (AEs), contributing to hospital morbidity and mortality. To mitigate premature transitioning, an ICU discharge readiness checklist (ICU-DRC) was developed. Enhanced (PSC) is crucial for reducing AEs and improving outcomes. Given the pressing need to enhance PSC in ICUs, this study evaluates the impact of ICU-DRC implementation on PSC, aiming to address a critical gap in quality improvement. A prospective quasi-experimental study assessed PSC before and after a year-long ICU-DRC intervention at Merkur Clinical Hospital in Zagreb, Croatia. Healthcare providers from two distinct ICUs participated voluntarily in the . The surgical ICU, where the intervention was applied, employed 106 providers, while the medical ICU, which did not implement the intervention, had 42 providers. Initial response rates were 58% for the intervention group and 45% for the control group, with post-intervention rates of 53% and 48%, respectively. The ICU-DRC was utilized with a fidelity of 65.7%. Due to the non-normal distribution found for most variables, non-parametric analytical procedures were applied. In baseline measurements, the control group outperformed the intervention group in three out of fourteen PSC dimensions. Post-intervention, PSC scores in the intervention group significantly improved in one dimension, whereas three dimensions in the control group showed significant declines, resulting in superior PSC outcomes for four dimensions in the intervention group during the second measurement. Applying the ICU-DRC as an isolated safety intervention aimed at optimizing ICU patient throughput resulted in observable patterns of improvement in several PSC dimensions, with statistically significant changes in specific areas.
将患者从重症监护病房（ICU）转出会带来发生不良事件（AE）的重大风险，进而导致医院的发病率和死亡率上升。为了减少过早转出，制定了一份ICU出院准备清单（ICU-DRC）。强化的患者安全文化（PSC）对于减少不良事件和改善结局至关重要。鉴于迫切需要在ICU中强化PSC，本研究评估了实施ICU-DRC对PSC的影响，旨在填补质量改进方面的一个关键空白。一项前瞻性准实验研究评估了在克罗地亚萨格勒布的梅尔库临床医院进行为期一年的ICU-DRC干预前后的PSC情况。来自两个不同ICU的医疗服务提供者自愿参与了该研究。实施干预的外科ICU有106名医疗服务提供者，而未实施干预的内科ICU有42名医疗服务提供者。干预组的初始应答率为58%，对照组为45%，干预后的应答率分别为53%和48%。ICU-DRC的使用保真度为65.7%。由于发现大多数变量呈非正态分布，因此应用了非参数分析程序。在基线测量中，对照组在14个PSC维度中的3个维度上表现优于干预组。干预后，干预组的PSC分数在一个维度上显著提高，而对照组的3个维度出现显著下降，导致在第二次测量时干预组在4个维度上的PSC结果更优。将ICU-DRC作为一项旨在优化ICU患者周转率的单独安全干预措施应用，导致在几个PSC维度上出现了可观察到的改善模式，在特定领域有统计学上的显著变化。
