为澳大利亚中度至重度创伤性脑损伤的最佳急性期管理制定一套质量指标。

IF 3.1 3区 医学 Q2 CLINICAL NEUROLOGY
Toby Jeffcote, Camila R Battistuzzo, Rebecca Roach, Catherine Bell, Cino Bendinelli, Stephen Rashford, Ron Jithoo, Belinda J Gabbe, Oliver Flower, Gerard O'Reilly, Lewis T Campbell, D James Cooper, Zsolt J Balogh, Andrew A Udy
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引用次数: 0

摘要

背景:本研究旨在制定一套基于共识的高质量急性中重度创伤性脑损伤(msTBI)临床管理指标,用于衡量可能影响患者预后的结构、过程和结果因素。这是 PRECISION-TBI 计划的第一阶段,该计划是一项前瞻性队列研究,旨在确定并促进澳大利亚 msTBI 的最佳临床管理:方法:根据现有证据初步制定了 45 项质量指标。由该领域知名专家组成的咨询委员会从内容覆盖、比例代表、污染和支持证据等方面对初步指标集进行了完善。然后,将完善后的指标集分发给更广泛的德尔菲小组,从有效性、测量可行性、可变性和行动可行性等方面对每个指标进行评估。最终指标集的纳入取决于预先规定的纳入评分:该指标集是根据毫秒创伤性脑损伤的护理路径构建的,包括院前、急诊科、神经外科、重症监护和康复指标。测量领域包括结构指标、逻辑指标和临床管理指标。德尔菲小组由 44 名参与者组成(84% 为医生,12% 为护理人员,4% 为初级研究人员),中位从业年限为 15 年。在第二轮德尔菲法得出的 47 个指标中,有 32 个指标得到了德尔菲小组的认可:本研究确定了一套 32 项质量指标,可用于构建数据收集结构,以推动毫秒创伤性脑损伤临床管理的质量改进。这些指标还将用于指导对 PRECISION-TBI 参与机构的反馈。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Development of a Quality Indicator Set for the Optimal Acute Management of Moderate to Severe Traumatic Brain Injury in the Australian Context.

Development of a Quality Indicator Set for the Optimal Acute Management of Moderate to Severe Traumatic Brain Injury in the Australian Context.

Background: The aim of this study was to develop a consensus-based set of indicators of high-quality acute moderate to severe traumatic brain injury (msTBI) clinical management that can be used to measure structure, process, and outcome factors that are likely to influence patient outcomes. This is the first stage of the PRECISION-TBI program, which is a prospective cohort study that aims to identify and promote optimal clinical management of msTBI in Australia.

Methods: A preliminary set of 45 quality indicators was developed based on available evidence. An advisory committee of established experts in the field refined the initial indicator set in terms of content coverage, proportional representation, contamination, and supporting evidence. The refined indicator set was then distributed to a wider Delphi panel for assessment of each indicator in terms of validity, measurement feasibility, variability, and action feasibility. Inclusion in the final indicator set was contingent on prespecified inclusion scoring.

Results: The indicator set was structured according to the care pathway of msTBI and included prehospital, emergency department, neurosurgical, intensive care, and rehabilitation indicators. Measurement domains included structure indicators, logistic indicators, and clinical management indicators. The Delphi panel consisted of 44 participants (84% physician, 12% nursing, and 4% primary research) with a median of 15 years of practice. Of the 47 indicators included in the second round of the Delphi, 32 indicators were approved by the Delphi group.

Conclusions: This study identified a set of 32 quality indicators that can be used to structure data collection to drive quality improvement in the clinical management of msTBI. They will also be used to guide feedback to PRECISION-TBI's participating sites.

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来源期刊
Neurocritical Care
Neurocritical Care 医学-临床神经学
CiteScore
7.40
自引率
8.60%
发文量
221
审稿时长
4-8 weeks
期刊介绍: Neurocritical Care is a peer reviewed scientific publication whose major goal is to disseminate new knowledge on all aspects of acute neurological care. It is directed towards neurosurgeons, neuro-intensivists, neurologists, anesthesiologists, emergency physicians, and critical care nurses treating patients with urgent neurologic disorders. These are conditions that may potentially evolve rapidly and could need immediate medical or surgical intervention. Neurocritical Care provides a comprehensive overview of current developments in intensive care neurology, neurosurgery and neuroanesthesia and includes information about new therapeutic avenues and technological innovations. Neurocritical Care is the official journal of the Neurocritical Care Society.
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