Athena T Samaras, Alison E Sweeney, Emilee C Lewis, Julie A Thompson, Julee Waldrop
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引用次数: 0
摘要
背景：新生儿溶血病（HDN）是一种罕见的疾病，具有潜在的高发病率。当地问题：在一家大型产科护理中心的实践与美国儿科学会（AAP）修订的高胆红素血症指南不一致。方法：采用实施前/实施后计划-实施-研究-实施循环设计。干预措施：实施了一项临床途径，以改善及时评估由于使用脐带血的母亲抗体阳性而有HDN风险的新生儿。结果：在实践改变前不符合采集标准的新生儿亚群中脐带血检测增加（前：0% n = 7，后：39% n = 23）。错过脐带血检测机会的发生频率较低（错过机会间隔为35天和26天）。可行性数据表明需要教育和临床工具。结论：临床途径和量身定制的工具支持AAP的推荐。电子健康记录支持可以促进未来的努力。
Improving Timely Evaluation of Newborns at Risk for Hemolytic Disease From a Positive Maternal Antibody.
Background: Hemolytic disease of the newborn (HDN) is a rare condition with the potential for high morbidity.
Local problem: Practice at a large maternity care center did not align with the American Academy of Pediatrics (AAP) revised hyperbilirubinemia guidelines.
Methods: A pre/post-implementation design with Plan-Do-Study-Act cycles was used.
Interventions: A clinical pathway was implemented to improve timely evaluation of newborns at risk for HDN due to a positive maternal antibody using cord blood.
Results: Cord blood testing increased among the subset of newborns who did not meet collection criteria prior to the practice change (pre: 0% n = 7, post: 39% n = 23). Missed opportunities to test cord blood occurred less frequently post (35 versus 26 days between missed opportunities). Feasibility data identified the need for educational and clinical tools.
Conclusions: A clinical pathway and tailored tools support the AAP recommendation. Electronic health record supports could bolster future efforts.
期刊介绍：
Journal of Nursing Care Quality (JNCQ) is a peer-reviewed journal that provides practicing nurses as well as nurses who have leadership roles in nursing care quality programs with useful information regarding the application of quality principles and concepts in the practice setting. The journal offers a forum for the scholarly discussion of “real world” implementation of quality activities.
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