The Status of Quality Improvement Programs for Pediatric Traumatic Brain Injury Care in Argentina.
The Status of Quality Improvement Programs for Pediatric Traumatic Brain Injury Care in Argentina.
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阿根廷小儿创伤性脑损伤护理质量改进计划的现状。
DOI：
10.1016/j.jss.2021.03.024
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发表时间：
2021-09
期刊：
影响因子：
--
通讯作者：
PEGASUS-Argentina author group
中科院分区：
文献类型：
--
作者：
Lujan S;Petroni G;Castellani P;Bollada S;Bell MJ;Velonjara J;Vavilala MS;Mock C;PEGASUS-Argentina author group
创伤质量改善（QI）计划改善受伤患者的护理和结果。在拉丁美洲，关于儿童创伤性脑损伤（TBI）的QI计划的信息很少。我们收集了15家阿根廷医院的QI项目和活动的数据，包括儿科TBI。数据是在2019年收集的，包括医院特征、QI实践、可查询登记处的存在以及TBI护理协议的使用。使用Fisher精确检验比较医院类型之间的QI活动水平。大多数医院都有儿科TBI护理指南，包括颅内压（100%）和中心线相关感染（87%）的管理/预防。所有医院都举行了发病率和死亡率会议或其他类型的病例讨论，其中讨论了儿科TBI护理的质量，大多数（53%）每周举行一次会议，但27%举行罕见或年度会议。60%的医院有足够的数据进行病例审查（少于25%的病例缺少基本信息）。53%的人记录了这些会议上发生的讨论，53%的人使用了计算机创伤登记。较大的医院（>200张病床）比较小的医院（29%，p=0.046）更经常有足够的数据进行病例审查（88%）。医院规模并不影响其他QI活动。大多数医院都有儿科TBI护理指南。在合理频繁的病例会议上讨论了护理的可持续性。改进的机会包括增加病例审查的文件记录，提高病例审查数据的充分性，特别是在较小的医院。更多地使用计算机化创伤登记可以提供这样的数据。
Trauma quality improvement (QI) programs improve care and outcomes for injured patients. Information about QI programs for pediatric traumatic brain injury (TBI) is sparse in Latin America. We gathered data on the status of QI programs and activities that encompass pediatric TBI at 15 Argentine hospitals. Data were gathered during 2019 and included hospital characteristics, QI practices, presence of a queryable registry, and use of protocols for TBI care. Level of QI activities was compared between hospital types using Fisher’s exact test. Most hospitals had guidelines for pediatric TBI care, including management/prevention of intracranial pressure (100%) and central-line-associated infections (87%). Morbidity and mortality meetings or other types of case discussions in which quality of pediatric TBI care was discussed were held by all hospitals, with most (53%) having weekly-monthly meetings, but 27% having rare or annual meetings. Sixty percent of hospitals had adequate data for case reviews (fewer than 25% of cases with essential information missing). Fifty-three percent documented discussions that occurred at these meetings and 53% utilized computerized trauma registries. Larger hospitals (>200 beds) more frequently had adequate data (88%) for case reviews than smaller hospitals (29%, p=0.046). Hospital size did not affect other QI activities. Most hospitals had guidelines for pediatric TBI care. Adequacy of care was discussed at reasonably frequent case conferences. Opportunities for improvement include increasing documentation of case reviews and improving adequacy of data for case reviews, especially at smaller hospitals. Greater use of computerized trauma registries could provide such data.
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影响因子：
36.4
作者：
Vavilala, Monica S.;King, Mary A.;Johnston, Brian D.
通讯作者：
Johnston, Brian D.
影响因子：
2.6
作者：
LaGrone, Lacey N.;Fuhs, Amy K.;Mock, Charles N.
通讯作者：
Mock, Charles N.
DOI：
10.1016/j.injury.2017.03.003
发表时间：
2017-09-01
影响因子：
2.5
作者：
LaGrone, Lacey N.;Romani Pozo, Diego A.;Mock, Charles N.
通讯作者：
Mock, Charles N.
DOI：
10.1097/pcc.0000000000000698
发表时间：
2016-05
期刊：
Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
影响因子：
--
作者：
Graves JM;Kannan N;Mink RB;Wainwright MS;Groner JI;Bell MJ;Giza CC;Zatzick DF;Ellenbogen RG;Boyle LN;Mitchell PH;Rivara FP;Wang J;Rowhani-Rahbar A;Vavilala MS;Pediatric Guideline Adherence and Outcomes Study
通讯作者：
Pediatric Guideline Adherence and Outcomes Study
影响因子：
3.7
作者：
Vavilala MS;Lujan SB;Qiu Q;Bell MJ;Ballarini NM;Guadagnoli N;Depetris MA;Faguaga GA;Baggio GM;Busso LO;García ME;González Carrillo OR;Medici PL;Sáenz SS;Vanella EE;Farr CK;Petroni GJ
通讯作者：
Petroni GJ