质量改进(QI)举措对新生儿死亡率的影响在新生儿重症监护病房:回顾性分析在印度西部三级保健中心

Q4 Medicine
Prabhudev Basavaraj Hasbi, Jitendra Kumar Jain, Mohit Ajmera, Gopikishan Sharma, Chetan Meena, Amrita Mayanger
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引用次数: 0

摘要

导言:在过去三十年中,全球“五岁以下儿童死亡率”从1990年的每千名活产死亡93人下降到2020年的37人,下降了60%。至关重要的是,必须采取行之有效的质量改进举措,提供高质量的护理,以降低新生儿死亡率和发病率。本研究的目的是评估质量改进干预措施和策略对降低新生儿死亡率统计数据的影响。 方法:本研究在印度一家拥有500个床位的政府医院进行。管理层实施了各种策略,如加强现有的基础设施,升级设备,增加劳动力,并实施既定的临床方案,以提高重症监护病房提供的服务质量。根据NICU前QI实施工作中发现并入围的缺点确定QI点。结果以新生儿死亡率指标来衡量,并比较实施前后的数据。 结果:实施质量改进措施后,总建筑面积、技术人员和设备的可用性均有显著提高。新生儿重症监护病房的总入院人数增加了79%,死亡率从20.93%下降到7.82%。疾病特异性新生儿死亡率有统计学显著下降,p值小于0.001。 结论:在新生儿重症监护病房实施适当和全面的QI干预和策略有助于降低新生儿死亡率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Impact of Quality Improvement (QI) Initiatives on Neonatal Mortality in NICU: A Retrospective Analysis in Tertiary Care Centre in Western India
Introduction: The global “under-five mortality” has dropped 60% from 93 deaths per 1,000 live births in 1990 to 37 in 2020 in the last three decades. It is vital to adopt proven quality improvement initiatives to provide quality care to improve neonatal mortality and morbidity. Aim of the study was to assess the impact of the quality improvement interventions and strategies in reducing the neonatal mortality statistics. Methods: The study was conducted in a 500 bedded Government Hospital in India. The management implemented various tactics, such as enhancing the existing infrastructure, upgrading equipment, augmenting the workforce, and implementing established clinical protocols, to enhance the quality of intensive care services provided in the NICU. The QI points were identified based on the shortcomings that were identified and shortlisted based on the working of NICU pre QI implementation. The outcome was measured as neonatal mortality indicators and the data was compared between pre and post implementation period. Results: After implementing quality improvement measures, there were notable enhancements in the total floor area, availability of skilled personnel, and equipment. The number of total admissions to the NICU increased by 79%, and mortality reduced from 20.93% to 7.82%. There was a statistically significant decrease in disease-specific neonatal mortality rates, with a p-value of less than 0.001. Conclusions: This study concludes that implementation of proper and comprehensive QI interventions and strategies in NICUs can help in decreasing the neonatal mortality.
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来源期刊
Journal of Nepal Paediatric Society
Journal of Nepal Paediatric Society Medicine-Pediatrics, Perinatology and Child Health
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