导言所有术前创伤患者都应接受术前药物治疗，无论患者为零（NPO）。抗凝剂,血管紧张素转换酶抑制剂（ACE-I），和血管紧张素II受体阻滞剂（ARB）应省略。这是根据地方和国家的指导方针。我们注意到，一些术前患者在手术前没有接受早上的药物治疗。这导致了术前和围手术期并发症。本研究的目的,因此,进行质量改进项目，以评估术前创伤患者在术前接受NPO时是否接受处方药物。然后，我们旨在确定与遗漏相关的不良结果，并进一步设计一个强大的系统来防止复发。方法从手术当天的相关患者药物图表中收集数据。这些病例可在每日创伤清单上找到。我们评估了没有提供药物的明确原因。在第一轮之后，我们实施了行动计划，将海报贴在骨科病房的药物推车上，并告知护理人员需要给予术前药物。我们认为以下是重要的药物类别：钙通道阻滞剂，神经调质，β受体阻滞剂，抗癫痫药,地高辛,支气管扩张剂,反心绞痛,抗癫痫药,和苯二氮卓类药物.一个月后对其进行了重新审核，以评估合规性并监督改进情况。结果第一轮共纳入患者40例，重新审核41例。在第一轮中，16/41（39％）患者正确接受了药物治疗。在没有接受药物治疗的患者中（n=25），22省略了重要的药物分类。海报的实施后，25/41（61％）患者正确接受了药物治疗。在没有接受药物治疗的患者中（n=16），10个省略了重要的药物类别。不正确给予药物的主要原因是患者是NPO。结论本次质量改进审核表明，我们在审核周期之间的干预措施在接受药物治疗的患者中取得了显着改善，因此这对患者安全和结果具有直接的积极影响。我们应该继续与护理人员保持密切的关系，以保持正确的实践标准，此后，这些审计结果应上报给应急剧院。
Introduction All preoperative trauma patients should receive their preoperative medications regardless of being nil per os (NPO). Anticoagulants, angiotensin-converting enzyme inhibitors (ACE-I), and angiotensin II receptor blockers (ARBs) should be omitted. This is according to both local and national guidelines. We noticed that some preoperative patients have not been receiving their morning medications prior to having their operations. This has led to pre and perioperative complications. The aim of this study, therefore, was to conduct a quality improvement project to assess if preoperative trauma patients are receiving their prescribed medications preoperatively when placed NPO. We then aimed to determine the adverse outcome associated with omission and to furthermore devise a robust system to prevent recurrence. Methods Data were collected from the relevant patients\' drug charts on the day of the operation. These cases were available on the daily trauma list. We evaluated if there was any clear reason documented for not providing the medications. Following the first round, we implemented our action plan for posters to be taped to drug trolleys on the orthopedic wards and informed the nursing staff of the need to give preoperative medications. We deemed the following to be important medication classes: calcium channel blockers, neuromodulators, beta-blockers, anti-epileptics, digoxin, bronchodilators, anti-anginals, anti-epileptics, and benzodiazepines. This was re-audited after one month to assess compliance and monitor for improvement. Results Forty patients were included in the first round and 41 in the re-audit. In the first round, 16/41 (39%) patients received their medications correctly. In patients who did not receive their medications (n=25), 22 had important medication classes omitted. Post implementation of the posters, 25/41 (61%) patients received their medications correctly. In patients who did not receive their medications (n=16), 10 had important medication classes omitted. The main reason why medications were incorrectly not given was that patients were NPO. Conclusion This quality improvement audit shows that our interventions between audit cycles have made a significant improvement in patients receiving their medications and therefore this has a direct positive impact on patient safety and outcomes. We should continue to have a close rapport with the nursing staff to maintain standards of correct practice, and these audit findings should be escalated to the emergency theatre thereafter.
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