quality care

优质护理
  • 文章类型: Journal Article
    背景:随着医疗技术的不断进步,神经外科护理不断发展和完善,提供更优质的护理服务。
    目的:探讨神经外科护理中不同类型优质护理对临床护理质量及患者满意度的影响。
    方法:选择2020年6月至12月在西南医科大学附属医院接受神经外科治疗的80例患者作为研究对象,分为研究组和对照组。研究组由40名患者组成,他们接受了4种不同类型的优质护理,而对照组包括40例接受常规护理的患者。经过一段特定的时期,比较两组患者的护理满意度、不良事件及并发症发生率。
    结果:对高质量护理的满意度高于常规护理,高质量的卫生服务和区域服务表现出最高的满意度,格拉斯哥量表的平均得分为12分。研究组和对照组的满意度分别为75%和57%,分别,差异具有统计学意义(t=7.314,P<0.05)。在护理期间,III级病理分级和神经外科手术患者的不良事件和并发症发生率最高(40.02%和85.93%,分别),差异有统计学意义。
    结论:在神经外科护理中,采用适当的优质护理方法可以有效降低患者的不良事件和并发症发生率,从而提高护理质量,增加临床护理价值。
    BACKGROUND: With continuous advancements in medical technology, neurosurgical nursing is constantly developing and improving to provide higher-quality nursing services.
    OBJECTIVE: To explore the effects of different types of high-quality nursing care on clinical nursing quality and patient satisfaction in neurosurgical nursing.
    METHODS: Eighty patients who received neurosurgical treatment in the Affiliated Hospital of Southwest Medical University from June to December 2020 were selected as study participants and categorised into study and control groups. The study group comprised 40 patients who received 4 different types of high-quality nursing care, whereas the control group comprised 40 patients who received conventional nursing care. After a specific period, nursing satisfaction levels and adverse event and complication rates were compared between the two groups.
    RESULTS: Satisfaction with high-quality care was higher than that with conventional care, and high-quality health services and regional services showed the highest satisfaction levels, with an average score of 12 on the Glasgow scale. The satisfaction levels of the study and control groups were 75% and 57%, respectively, with a statistically significant difference (t = 7.314, P < 0.05). During the nursing period, the adverse event and complication rates were the highest in patients with level III pathology grade and those who underwent neurosurgery (40.02% and 85.93%, respectively), and the difference was statistically significant.
    CONCLUSIONS: In neurosurgical nursing, employing appropriate high-quality nursing methods can effectively reduce adverse event and complication rates in patients, thereby improving the quality of nursing care and increasing clinical nursing value.
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  • 文章类型: Journal Article
    背景:国际上,不断努力开发患者投诉渠道,以了解患者对护理的体验和期望,从而指导卫生服务质量的提高。尽管患者反馈的价值是一致的,对使用患者反馈来预测和促进实际质量改进举措的关注有限。
    目的:确定从公共反馈热线收集的患者反馈是否可用于预测医院优质服务改进措施的效果。
    方法:对某三甲医院2018-2021年患者投诉资料进行回顾性分析。首先通过澳大利亚医院患者体验问题集的标准分类方法对患者投诉进行编码。然后通过频率和列联表分析分析患者投诉的特征。最后,通过非参数Mann-Kendall检验和Joinpoint回归模型,测试了每个投诉特征的趋势。
    结果:在收到的771起针对临床医生的投诉中,其中约有75%与医生有关。“伤害和痛苦”是投诉的主要原因,接着是“不关心”,\'缺乏自信\',\'需要未满足\'和\'未通知\'。2021年,与医生造成的中度“伤害和困扰”有关的投诉数量比2020年增加了667%。\'未通知\'的类别,“不关心”和“伤害和痛苦”也在上升,具有统计学意义。此外,与缺乏尊重有关的投诉,还记录了护士(n=83)和医生(n=121)表现出的不良态度和不专业行为。
    结论:通过公共反馈热线收集的患者反馈为深入了解患者的护理体验提供了一个有用的平台,这对于指导优质护理改进是有价值的。为了提高护理质量,临床医生需要在早期阶段参与质量改进策略的制定.需要努力改善医生与患者之间的沟通和互动,以改善患者的护理体验并发展患者对临床医生和医疗服务的信任。该研究强调了使用公共反馈热线来产生可以指导医院服务改善的证据的价值。
    BACKGROUND: Internationally, continuous efforts have been put into developing patient complaint channels to understand patients\' experience and expectation of care, which can guide the improvement of health service quality. Despite agreement among the value of patient feedback, limited attention has been paid to using patient feedback to predict and promote the actual quality improvement initiatives.
    OBJECTIVE: To determine whether patient feedback collected from a public feedback hotline can be used to predict the effect of hospital quality service improvement initiatives.
    METHODS: A retrospective analysis of patient complaint data of a tertiary hospital from 2018 to 2021 was performed. Patient complaints were first coded by the standard classification method of the Australian Hospital Patient Experience Question Set. The characteristics of patients\' complaints were then analysed by frequency and contingency table analysis. Finally, through Nonparametric Mann-Kendall test and Joinpoint regression model, the trends of each complaint characteristics were tested.
    RESULTS: Amongst the 771 complaints received against clinicians, approximately 75% of them were concerning doctors. \'Harm and distress\' was the key reason of complaints, followed by \'not cared for\', \'lack of confidence\', \'needs unmet\' and \'not informed\'. In 2021, the number of complaints received in relation to moderate \'harm and distress\' caused by doctors increased by 667% from 2020. The categories of \'not informed\', \'not cared for\' and \'harm and distress\' were also on the rise with statistical significance. In addition, complaints related to the lack of respect, bad attitude and unprofessional behaviour demonstrated by nurses (n = 83) and doctors (n = 121) were also recorded.
    CONCLUSIONS: Patient feedbacks collected via a public feedback hotline provides a useful platform to gain insight into patient experience of care which are valuable to guide quality care improvement. To improve the care quality, clinicians need to participate in quality improvement strategies development at an early stage. Efforts in improving communication and interaction between doctors and patients are needed to improve patients\' experience of care and developing patients\' trust in both of the clinicians and the medical services. The study highlights the value of using public feedback hotline to generate evidence that can guide hospital service improvement.
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  • 文章类型: Journal Article
    目的:研究患者报告的同情经历对整体患者质量护理评级的独特贡献。此外,我们评估患者在急诊科报告的同情经历在社会人口统计学组之间是否存在差异。
    方法:这项横断面研究的省级数据是从2022年3月1日至2022年9月5日从艾伯塔省的14个急诊科收集的,加拿大。来自4501名急诊科患者的数据(53.6%为女性,77.1%白色/欧洲)进行分析。主要结果是患者在最近一次ED访视期间的总体质量护理评级。分层逐步回归中包括的措施包括人口统计,以及从急诊科患者护理体验(EDPEC)问卷中提取的数据:患者信息的单项和多项测量(例如,患者感知健康)和患者体验(例如,医师沟通),和同情心(例如,辛克莱同情问卷;SCQ-ED)。
    结果:分析了4501例ED患者的数据。逐步分层线性多元回归表明,在21个包含变量中,同情心最强烈地预测总体质量护理评级(b=1.61,95%CI1.53-1.69,p<.001,f2=.23),解释了超过所有其他衡量标准的19%的独特差异。单向方差分析表明,平均同情心得分存在显著的人口统计学差异,这样女人(vs.男性)报告较低的同情心(MD=-.15,95%CI=-.21,-.09,p<.001),和土著(vs.白人)患者的同情心较低(MD=-.17,95%CI=-.34,-.01,p=.03)。
    结论:同情心被认为是ED整体质量护理评级的关键贡献者,同情的经历随着人口统计学的变化而变化。患者报告的同情心是质量护理的指标,需要正式纳入临床护理和质量护理评估。
    OBJECTIVE: To examine the unique contribution of patient reported experiences of compassion to overall patient quality care ratings. Additionally, we assess whether patients\' reported experiences of compassion in the emergency department differed between sociodemographic groups.
    METHODS: Provincial data for this cross-sectional study were collected from 03/01/2022 to 09/05/2022 from 14 emergency departments in Alberta, Canada. Data from 4501 emergency department patients (53.6% women, 77.1% White/European) were analyzed. The primary outcome was patients\' overall quality care ratings during their most recent ED visit. Measures included in the hierarchical stepwise regression included demographics, and those drawn from the Emergency Department Patient Experience of Care (EDPEC) questionnaire: single and multi-item measures of patient information (e.g., patient perceptions health) and patient experience (e.g., physician communication), and compassion (e.g., Sinclair Compassion Questionnaire; SCQ-ED).
    RESULTS: Data from 4501 ED patients were analysed. Stepwise hierarchical linear multiple regression indicated that of 21 included variables, compassion most strongly predicted overall quality care ratings (b=1.61, 95% CI 1.53-1.69, p<.001, f2=.23), explaining 19% unique variance beyond all other measures. One-way ANOVAs indicated significant demographic differences in mean compassion scores, such that women (vs. men) reported lower compassion (MD=-.15, 95% CI=-.21, -.09, p<.001), and Indigenous (vs. White) patients reported lower compassion (MD=-.17, 95% CI =-.34, -.01, p=.03).
    CONCLUSIONS: Compassion was identified as a key contributor to ED overall quality care ratings, and experiences of compassion varied as a function of demographics. Patient-reported compassion is an indicator of quality care that needs to be formally integrated into clinical care and quality care assessments.
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  • 文章类型: Case Reports
    子宫平滑肌瘤(ULs)是常见的良性肿瘤,在很大一部分女性中可以根据其在子宫内的位置进行分类。它们可以引起许多骨盆并发症,并且可以进行医学管理,但更常见的是手术。子宫肌瘤常发生在产后,可能是梗塞,并可能导致变性和败血症。我们的病人出现了两个月的潜在化脓性肌瘤,最初在计算机断层扫描(CT)上发现。办公室检查显示子宫颈有突出的肿块,并尝试切除,但最终因疼痛而推迟进行全身麻醉检查。切除平滑肌瘤并显示坏死。化脓性肌瘤通常是阴险的,并且通常可以模仿其他有关的病理。现代成像可以显示骨盆内的病变,但难以在液体收集和可能的梗塞肿块之间进行确定。在这种情况下,质量护理措施的重要性值得强调,以防止严重的并发症。
    Uterine leiomyomas (ULs) are common benign tumors seen in a large percent of women that can be classified based on their location within the uterus. They can cause a number of pelvic complications and can be managed medically, but more often surgically. Uterine pyomyomas often occur postpartum, possibly from infarction, and can lead to degeneration and sepsis. Our patient presents with a two-month development of a potential pyomyoma, found initially on computed tomography (CT). Office exam reveals a protruding mass from the cervical os, and removal was attempted but ultimately postponed for general anesthesia exam due to pain. The leiomyoma was removed and shown to be necrosing. Pyomyomas are often insidious and can often mimic other concerning pathologies. Modern imaging can show lesions within the pelvis but struggle to determine between fluid collection and possible infarcted masses. The importance of quality care measures in cases like this deserve to be emphasized to prevent serious complications.
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  • 文章类型: Journal Article
    目标:作为一项更大的混合方法研究的一部分,以更好地定义佐治亚州获得SRH护理的公平性,本分析旨在了解:1)个人如何为其SRH服务定义优质护理;2)在寻求SRH护理时,护理质量如何显著.
    方法:从2019年1月到2020年2月,我们对佐治亚州郊区有怀孕能力的人进行了生活史访谈。我们使用主题分析法对访谈进行了分析。
    结果:SRH护理质量是由健康中心环境的经验决定的,与供应商,和工作人员。研究参与者强调了与可信的SRH护理相关的因素,如表现出同情心,尊重和不评判,花时间,提供信息,和保证机构。参与者还表达了对解决个人生活经历的整体护理的愿望。参与者在寻求护理时考虑了护理质量,但有时不得不权衡对质量的偏好与负担能力问题。
    结论:获得以人为中心的优质护理是实现获得SRH服务的重要组成部分。公平获取和质量的措施应考虑到优质护理的经验,其中包括提供者和员工的互动以及更大的医疗保健环境和使用优质护理的能力,尽管存在财务限制。
    结论:优质的计划生育护理应包括临床医生和工作人员,以表现出同情心,提供尊重和非评判性的护理,花时间和病人在一起,提供信息,确保机构在决策中,以及解决个人的生活经验。
    OBJECTIVE: As part of a larger mixed-methods study to better define equity in access to sexual and reproductive health (SRH) care in Georgia, this analysis sought to understand: (1) how individuals define quality care for their SRH services; and (2) how quality of care is salient in their SRH care-seeking.
    METHODS: From January 2019 to February 2020, we conducted life history interviews with individuals with the capacity to become pregnant in suburban areas in Georgia. We analyzed interviews using thematic analysis.
    RESULTS: SRH care quality was shaped by experiences with health center environment, with providers, and with staff. Study participants emphasized elements associated with trusted SRH care such as showing compassion, respecting and non-judging, taking time, providing information, and assuring agency. Participants also voiced a desire for holistic care that addressed the lived experiences of the individual. Participants took quality of care into account when care-seeking but sometimes had to weigh out preferences for quality with issues of affordability.
    CONCLUSIONS: Access to quality person-centered care is an essential component of realized access to SRH services. Measures of equitable access and quality should account for experiences of quality care that include both provider and staff interactions as well as the larger healthcare environment and ability to use quality care despite financial constraints.
    CONCLUSIONS: Quality family planning care should involve both clinicians and staff to incorporate showing compassion, providing respectful and non-judgmental care, taking time with patients, providing information, assuring agency in decision-making, as well as addressing the lived experiences of individuals.
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  • 文章类型: Journal Article
    医疗机构提供的医疗保健应优先考虑家庭的需求,因为它提高了患者的护理质量。家庭满意度衡量医疗保健专业人员如何有效地解决家庭成员的感知需求和期望。众多因素,包括信息传播,通信,家庭动态,患者特征,医院设施,和护理过程,作为家庭满意度的预测因子。因此,这项研究旨在评估入住重症监护病房的患者家属对所接受护理的满意度。
    从2023年3月至6月,在多个中心进行了一项基于医院的横断面研究,涉及400名参与者。通过检查方差膨胀因子(VIF)来评估多重共线性,而拟合优度使用Hosmer和Lemeshow检验进行评估。使用双变量和多变量逻辑回归分析来确定与家庭满意度相关的因素。双变量逻辑回归中p值低于0.2的变量包括在多变量逻辑回归分析中。计算具有95%置信区间的调整后的赔率比(AOR)以指示关联强度。在多变量分析中,p值小于0.05的变量被认为具有统计学意义.
    家庭对重症监护室提供的护理的总体满意度为58.6%,95%置信区间为55.882%至61.241%。家庭对患者护理(64.8%)和专业护理(67.4%)的满意度较高。然而,他们报告说,对家庭提供的护理的满意度较低(52.2%),ICU环境(56.8%),家庭参与决策(55.8%)。缺乏正规教育(AOR:1.949,95%CI:1.005,4.169),完成初等教育(AOR:2.581,95%CI:1.327,5.021),并且完成9-12级(AOR:2.644,95%CI:1.411,4.952)与家庭总体满意度显著相关.
    总体满意度令人满意。为了提高服务质量和家庭满意度,医疗保健提供者应优先考虑与家庭成员进行有效和定期的沟通。让他们充分了解患者的病情和治疗计划至关重要。
    UNASSIGNED: Healthcare provided in medical facilities should prioritize the needs of families, as it enhances the quality of care for the patients. Family satisfaction gauges how effectively healthcare professionals address the perceived needs and expectations of family members. Numerous factors, including information dissemination, communication, family dynamics, patient characteristics, hospital facilities, and the caregiving process, serve as predictors of family satisfaction. Thus, this study seeks to evaluate the satisfaction of families with the care received by patients admitted to the intensive care unit.
    UNASSIGNED: A hospital-based cross-sectional study involving 400 participants was conducted across multiple centers from March to June 2023. Multicollinearity was assessed by examining variance inflation factors (VIF), while the goodness-of-fit was evaluated using the Hosmer and Lemeshow test. Both bivariable and multivariable logistic regression analyses were utilized to identify factors correlated with family satisfaction. Variables with a p-value below 0.2 in the bivariable logistic regression were included in the multivariable logistic regression analysis. Adjusted Odds Ratios (AORs) with 95% Confidence Intervals were computed to indicate the strength of association. In the multivariable analysis, variables with a p-value less than 0.05 were deemed statistically significant.
    UNASSIGNED: The overall family satisfaction with the care provided in the intensive care unit was 58.6%, with a 95% confidence interval ranging from 55.882% to 61.241%. Families expressed higher satisfaction levels with patient care (64.8%) and professional care (67.4%). However, they reported lower satisfaction levels regarding care provided for families (52.2%), the ICU environment (56.8%), and involvement of families in decision-making (55.8%). Lack of formal education (AOR: 1.949, 95% CI: 1.005, 4.169), completion of primary education (AOR: 2.581, 95% CI: 1.327, 5.021), and completion of grades 9-12 (AOR: 2.644, 95% CI: 1.411, 4.952) were found to be significantly associated with overall family satisfaction.
    UNASSIGNED: The overall level of satisfaction is satisfactory. To enhance service quality and family satisfaction, healthcare providers should prioritize effective and regular communication with family members. Keeping them well informed about the patient\'s condition and treatment plan is essential.
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  • 文章类型: Meta-Analysis
    系统评价优质护理对烧伤患者创面疼痛和焦虑的影响。PubMed的电脑搜索,谷歌学者,科克伦图书馆,Embase,万方,从数据库开始到2023年10月,对中国生物医学文献数据库和中国国家知识基础设施数据库进行了关于优质护理在烧伤患者中应用的随机对照试验(RCT)。根据纳入和排除标准,由两名研究人员筛选和评估文献。并从最终纳入的文献中提取数据。采用Stata17.0软件进行数据分析。总的来说,包括15例RCT和1115例烧伤患者,包括优质护理和常规护理组的563和552。结果发现,与常规护理相比,实施优质护理的烧伤患者伤口疼痛明显减轻(SMD:-1.79,95%CI:-2.22至-1.36,p<0.001),焦虑(SMD:-2.71。95%CI:-3.49至-1.92,p<0.001)和抑郁(SMD:-1.74,95%CI:-2.35至-1.14,p<0.001)水平在创伤后明显降低。
    To systematically evaluate the effects of quality nursing care on wound pain and anxiety in burn patients. Computerised searches of PubMed, Google Scholar, Cochrane Library, Embase, Wanfang, China Biomedical Literature Database and China National Knowledge Infrastructure databases randomised controlled trials (RCTs) on the application of quality nursing care to burn patients were carried out from database inception to October 2023. Literature was screened and evaluated by two researchers based on inclusion and exclusion criteria, and data were extracted from the final included literature. Stata 17.0 software was employed for data analysis. Overall, 15 RCTs and 1115 burn patients were included, including 563 and 552 in the quality care and routine care groups. It was found that, compared with routine care, burn patients who implemented quality care had significantly less wound pain (SMD: -1.79, 95% CI: -2.22 to -1.36, p < 0.001), anxiety (SMD: -2.71. 95% CI: -3.49 to -1.92, p < 0.001) and depression (SMD: -1.74, 95% CI: -2.35 to -1.14, p < 0.001) levels were significantly reduced post-trauma.
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  • 文章类型: Journal Article
    本工作通过实验检查了讲西班牙语的医疗保健提供者(身份安全提示)是否提高了拉丁裔美国人(N=180)的预期护理质量和医疗保健利用意图,以及这种影响是否受到种族中心性的缓和。我们发现提供西班牙语服务,而不是,在医疗机构的网页上显着提高了预期的护理质量和医疗保健利用意图-但仅限于认为自己的种族对自我概念至关重要的拉丁裔美国人。同样,我们发现,预期的护理质量仅在种族中心性高的拉丁裔美国人的身份安全线索对医疗保健利用意图的影响中起中介作用.这些发现表明,被证明是最容易受到歧视的少数民族成员(种族中心性高的人)也最有可能从旨在减轻这些担忧的身份安全线索中受益。
    The present work experimentally examines whether a Spanish-speaking healthcare provider (an identity safety cue) increases the anticipated quality of care and healthcare utilization intentions of Latinx Americans (N = 180) and whether this effect is moderated by ethnic centrality. We find that providing Spanish-language services, versus not, on a healthcare facility\'s webpage significantly increases both anticipated quality of care and healthcare utilization intentions-but only for Latinx Americans who perceive their ethnicity as highly central to their self-concept. Likewise, we find that anticipated quality of care mediates the effect that identity safety cues have on healthcare utilization intentions only for Latinx Americans high on ethnic centrality. These findings demonstrate that members of minoritized ethnic groups shown to be the most susceptible to experiencing concerns of discrimination (people high on ethnic centrality) are also the most likely to benefit from identity safety cues that are designed to mitigate these very concerns.
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  • 文章类型: Journal Article
    在文化和政治理想的背景下,本文强调了心理健康护理在满足人群需求方面的重要性,以及可能阻碍其充分实现这一目标的监管障碍。具体来说,我们考虑监管机构规定的护士教育中的“熟练程度”概念如何影响未来心理健康护士的发展及其心理健康护理身份。心理健康实践中的一个关键紧张关系是受制裁的权力在限制患者自由的同时,以及促进患者自主康复的愿望(和义务)所带来的道德法律挑战。英国未来护士标准的普遍性对心理健康护士做好准备,以应对随之而来的紧张局势。这对护士和病人都有影响,因为这两种风险都经历了给予或接受不良护理的痛苦和不和谐。我们认为,需要做更多的工作来使心理健康护士能够定义和阐明职业的细微差别,作为成为关键的一部分,有思想和自信的从业者。教育工作者可以通过调整课程来为这一使命做出贡献,教学方法和评估,为心理健康护理学生创造有意义的机会,以参与复杂的心理健康护理实践。没有这个,该行业的可信度将继续受到质疑;它的未来不确定。
    Against the backdrop of cultural and political ideals, this article highlights both the significance of mental health nursing in meeting population needs and the regulatory barriers that may be impeding its ability to adequately do so. Specifically, we consider how ambiguous notions of \'proficiency\' in nurse education-prescribed by the regulator-impact the development of future mental health nurses and their mental health nursing identity. A key tension in mental health practice is the ethical-legal challenges posed by sanctioned powers to restrict patients\' freedom at the same time as the desire (and obligation) to promote patients\' self-determined recovery. The genericism of the UK\'s Future Nurse Standards do little to prepare mental health nurses to navigate the tensions that ensue. This has consequences for nurses and patients alike, as both risk experiencing the distress and dissonance that attends giving or receiving poor care. We argue that more needs to be done to enable mental health nurses to define and articulate the nuances of the profession as part of becoming critical, thoughtful and confident practitioners. Educators can contribute to this mission by aligning curriculum, pedagogy and assessment to create meaningful opportunities for mental health nursing students to engage with the complexities of mental health nursing practice. Without this, the credibility of the profession will continue to be questioned; its future uncertain.
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  • 文章类型: Journal Article
    目的:描述加拿大三级新生儿重症监护病房(NICU)收治的中度和晚期早产儿(MLPI)的护理实践和临床结局的患病率和中心之间的差异。
    方法:一项回顾性队列研究,包括妊娠320/7至366/7周出生的婴儿,并在2015年至2020年期间接受了25个参与加拿大新生儿网络的NICU。患者特征,以护理实践为代表的过程措施,以临床住院和出院结局为代表的结局指标按孕周报告.在调整患者特征后,使用间接标准化比较NICU。
    结果:在25,669名婴儿(研究期间在加拿大出生的MLPI的17%)中,45%的人接受了延迟的电线夹紧,7%的人入院时体温过低,47%接受了无创呼吸支持,11%接受机械通气,8%的表面活性剂,40%的人在前3天接受了抗生素治疗,4%的人在前2天没有进食,77%有血管通路。死亡率,早发性败血症,迟发性败血症,或坏死性小肠结肠炎发生在<1%的研究队列。从入院医院出院的婴儿中,平均住院时间(IQR)为14(9-21)天,和5(3-9)天的婴儿转移到社区医院。在出院的婴儿中,33%的人使用纯母乳出院,75%的人使用任何母乳出院。在所有过程和结果测量中,NICU之间存在显着差异。
    结论:MLPI的护理实践和结果在加拿大NICU之间存在显著差异。该人群的过程和结果质量措施的标准化将使基准和研究成为可能,促进全系统的改进。
    OBJECTIVE: To describe the prevalence of and between-center variations in care practices and clinical outcomes of moderate and late preterm infants (MLPIs) admitted to tertiary Canadian neonatal intensive care units (NICUs).
    METHODS: This was a retrospective cohort study including infants born at 320/7 through 366/7 weeks of gestation and admitted to 25 NICUs participating in the Canadian Neonatal Network between 2015 and 2020. Patient characteristics, process measures represented by care practices, and outcome measures represented by clinical in-hospital and discharge outcomes were reported by gestational age weeks. NICUs were compared using indirect standardization after adjustment for patient characteristics.
    RESULTS: Among 25 669 infants (17% of MLPIs born in Canada during the study period) included, 45% received deferred cord clamping, 7% had admission hypothermia, 47% received noninvasive respiratory support, 11% received mechanical ventilation, 8% received surfactant, 40% received antibiotics in the first 3 days, 4% did not receive feeding in the first 2 days, and 77% had vascular access. Mortality, early-onset sepsis, late-onset sepsis, or necrotizing enterocolitis occurred in <1% of the study cohort. Median (IQR) length of stay was 14 (9-21) days among infants discharged home from the admission hospital and 5 (3-9) days among infants transferred to community hospitals. Among infants discharged home, 33% were discharged on exclusive breastmilk and 75% on any breastmilk. There were significant variations between NICUs in all process and outcome measures.
    CONCLUSIONS: Care practices and outcomes of MLPIs varied significantly between Canadian NICUs. Standardization of process and outcome quality measures for this population will enable benchmarking and research, facilitating systemwide improvements.
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