改善儿童和青少年嗜睡症患者的日间嗜睡：一项质量改善倡议。

IF 2.1 3区医学 Q2 CLINICAL NEUROLOGY

Pediatric neurology Pub Date : 2025-09-12 DOI:10.1016/j.pediatrneurol.2025.09.004

Neepa Gurbani DO , Thomas J. Dye MD , Danielle M. Simmons PhD , John E. Pascoe MD , Jennifer Bibbins RN , Amy Cole RRT, RPGST , Lisa Mullen MHSA , Christine L. Schuler MD, MPH , Narong Simakajornboon MD

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引用次数: 0

摘要

背景：我们试图改善儿童发作性睡病患者的日间嗜睡，目的是提高Epworth嗜睡量表（ESS）与基线相比改善至少30%的儿科患者的百分比。方法：我们召集了一个多学科团队，采用标准质量改进（QI）方法跟踪和改善白天嗜睡。干预措施包括工作人员提醒、改进就诊前计划工具、跟踪漏诊和随访时间、联系漏诊患者以及跟踪处方记录。我们进行了计划-执行-研究-行动循环，并创建了运行图表来跟踪进度。结果：2019年8月至2024年7月，共收治睡眠门诊发作性睡病患者105例。实施了几项流程改进。ESS完成率从60%提高到75%。在电子健康记录中有临床记录的随访时间框架的患者比例从最初的44%增加到86%，随后保持在77%。在2019年冠状病毒病大流行期间，在要求的随访日期后60天内返回诊所的发作性睡病患者百分比下降；此后一直保持在68%左右。最初，约72%的患者按处方服药。与基线相比，ESS改善30%的患者比例从47%提高到62%。此外，儿童生活质量量表评分提高10%的患者比例保持在75%左右。结论：采用气相法和各种干预措施，可改善儿童和青少年发作性睡病患者日间嗜睡评分。仍然需要多方面和创造性的策略来解决残余嗜睡，提高生活质量，并最大限度地提高患者的安全。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Improving Daytime Sleepiness in Children and Adolescents With Narcolepsy: A Quality Improvement Initiative

Background

We sought to improve daytime sleepiness in pediatric narcolepsy and aimed to increase the percentage of pediatric patients with at least 30% improvement on the Epworth Sleepiness Scale (ESS), compared with baseline.

Methods

We convened a multidisciplinary team and used standard quality improvement (QI) methods to track and improve daytime sleepiness. Interventions included staff reminders, previsit planning tool enhancement, tracking missed visits and time to follow-up, contacting patients with missed visits, and following prescription records. We conducted Plan-Do-Study-Act cycles and created run charts to track progress.

Results

From August 2019 to July 2024, 105 patients with narcolepsy were seen in sleep clinic. Several process improvements were implemented. ESS completion rate increased from 60% to 75%. The proportion of patients with a clinician-documented time frame for follow-up in the electronic health record increased from 44% to 86% initially and subsequently was maintained at 77%. The percentage of patients with narcolepsy who returned to clinic within 60 days of the requested follow-up date fell during the coronavirus disease 2019 pandemic; it has since remained approximately 68%. Initially, ∼72% of patients filled prescriptions. The percentage of patients with a 30% improvement in the ESS, compared with the baseline, improved from 47% to 62%. In addition, the percentage of patients with a 10% increase in Pediatric Quality of Life Inventory screen scores was maintained at approximately 75%.

Conclusions

Using QI methods and various interventions, we improved daytime sleepiness scores in children and adolescents with narcolepsy. Multifaceted and creative strategies are still needed to address residual sleepiness, improve quality of life, and maximize patient safety.

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来源期刊

Pediatric neurology 医学-临床神经学

CiteScore

4.80

自引率

2.60%

发文量

176

审稿时长

78 days

期刊介绍： Pediatric Neurology publishes timely peer-reviewed clinical and research articles covering all aspects of the developing nervous system. Pediatric Neurology features up-to-the-minute publication of the latest advances in the diagnosis, management, and treatment of pediatric neurologic disorders. The journal''s editor, E. Steve Roach, in conjunction with the team of Associate Editors, heads an internationally recognized editorial board, ensuring the most authoritative and extensive coverage of the field. Among the topics covered are: epilepsy, mitochondrial diseases, congenital malformations, chromosomopathies, peripheral neuropathies, perinatal and childhood stroke, cerebral palsy, as well as other diseases affecting the developing nervous system.