加强可靠性和可持续性:在质量改进协作中整合行业培训(TWI)。

Global journal on quality and safety in healthcare Pub Date : 2025-02-11 eCollection Date: 2025-02-01 DOI:10.36401/JQSH-24-37
Paulo Borem, Rafaela Moraes de Moura, Helena Barreto Dos Santos, Guilherme Cesar Silva Dias Santos, Patrícia Dos Santos Bopsin, Beatriz Ramos, Andrea Keiko Fujinami Gushken, Samara de Campos Braga, Edileusa Novaes Piusi, Priscila Martini Bernardi Garzella, Lais Silvestre Bizerra Baltazar, Karen Cristina da Conceição Dias Silva, Teilor Ricardo Dos Santos, Marco Antonio Saavedra Bravo, Ademir Jose Petenate, Cristiane Maria Reis Cristalda, Luciana Yumi Ue, Claudia Garcia de Barros, Sebastian Vernal
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引用次数: 0

摘要

简介:将流程改进工具集成到医疗保健中已经显示出有希望的结果,但在这种情况下,“行业内培训”(TWI)的应用仍需要探索。本研究的重点是在一个中等收入国家的大型突破系列协作(BTS)中实施工作指导(JI),这是TWI的三个组成部分之一。方法:我们评估了JI在全国范围内的部署,旨在减少三种严重的卫生保健相关感染(HAIs)-中央线相关血流感染(CLABSI),呼吸机相关肺炎(VAP)和导尿管相关尿路感染(CAUTI)-在189个巴西公共重症监护病房(ICUs)。我们的质量改进(QI)项目概述了JI的整合,以提高护理包的可靠性,并使一线团队能够减少变化,这是保持持续改进的一个基本条件。结果:实施策略包括对中心领导进行结构化的JI培训,促进了JI和可视化管理技术在ICU日常护理中的逐步采用和定制。我们详细介绍了JI培训的四个阶段、每个阶段的内容以及如何将它们与可视化管理工具一起纳入现有的BTS框架。预防束的平均依从性超过90%,CLABSI、VAP和CAUTI的项目结果分别降低了44%、52%和54%。结论:我们的研究结果表明JI可以无缝地整合到日常的QI活动中。这种结构促进了执行护理包各个方面的一致性,预防HAI和加强患者安全。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Strengthening Reliability and Sustainability: Integrating Training Within Industry (TWI) in a Quality Improvement Collaborative.

Introduction: Integrating process improvement tools into healthcare has shown promising results, yet the application of "training within industry" (TWI) still needs to be explored in this context. This study focuses on implementing job instruction (JI), one of the three components of TWI, within a large breakthrough series collaborative (BTS) in a middle-income country.

Methods: We evaluated the deployment of JI during a nationwide initiative aimed at reducing three critical healthcare-associated infections (HAIs)-central line-associated bloodstream infections (CLABSI), ventilator-associated pneumonia (VAP), and catheter-associated urinary tract infections (CAUTI)-across 189 Brazilian public intensive care units (ICUs). Our quality improvement (QI) project outlines the integration of JI to enhance the reliability of care bundles and empower frontline teams to reduce variation, one fundamental condition to maintain ongoing improvements.

Results: The implementation strategy included structured JI training for the hub's leaders, which facilitated the gradual adoption and customization of JI and visual management techniques into daily ICU care. We detailed the four stages of JI training, the content of each session, and how they were incorporated into the existing BTS framework alongside visual management tools. The mean compliance to prevention bundles exceeded 90%, and the project results reached an overall reduction of 44%, 52%, and 54% for CLABSI, VAP, and CAUTI, respectively.

Conclusion: Our findings suggest that JI can be seamlessly integrated into routine QI activities. This structure promotes consistency in carrying out each aspect of care bundles, preventing HAI and strengthening patient safety.

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