Checklists to guide the supportive and critical care of tuberculous meningitis.
Checklists to guide the supportive and critical care of tuberculous meningitis.
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DOI：
10.12688/wellcomeopenres.15512.2
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发表时间：
2019-01-01
影响因子：
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通讯作者：
Figaji, Anthony A
中科院分区：
文献类型：
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作者：
Donovan, Joseph;Rohlwink, Ursula K;Figaji, Anthony A
结核性脑膜炎（TBM）的评估和管理往往是复杂的，但没有标准化的方法存在，和病人的临床护理的证据，包括那些危重病，是有限的。形式和检查表的作用在医学上越来越多;形式提供了一个框架，一个彻底的方法来照顾病人，而检查表提供了一个基于优先级的方法，可应用于恶化的病人在时间紧迫的情况。我们的目标是为TBM患者制定一个全面的评估形式和一个附带的“优先事项”清单，首要目标是改善患者的预后。该形式概述了在初始评估和每日住院患者回顾时应询问、检查或测试的内容，以协助患者的支持性临床护理，并为重症监护患者提供了一份经过调整的列表。它还附有一份说明这些要点与隧道掘进机相关的原因的证明文件。我们的优先事项清单提供了一个有用的和简单的提醒重要的问题，以审查在一个时间紧迫的时期，急性病人恶化。这些文件对患者结局的益处需要调查;然而，我们希望它们将促进患者评估和护理的标准化，特别是对于严重不适的个体，其发病率和死亡率仍然高得不可接受。
The assessment and management of tuberculous meningitis (TBM) is often complex, yet no standardised approach exists, and evidence for the clinical care of patients, including those with critical illness, is limited. The roles of proformas and checklists are increasing in medicine; proformas provide a framework for a thorough approach to patient care, whereas checklists offer a priority-based approach that may be applied to deteriorating patients in time-critical situations. We aimed to develop a comprehensive assessment proforma and an accompanying 'priorities' checklist for patients with TBM, with the overriding goal being to improve patient outcomes. The proforma outlines what should be asked, checked, or tested at initial evaluation and daily inpatient review to assist supportive clinical care for patients, with an adapted list for patients in critical care. It is accompanied by a supporting document describing why these points are relevant to TBM. Our priorities checklist offers a useful and easy reminder of important issues to review during a time-critical period of acute patient deterioration. The benefit of these documents to patient outcomes would require investigation; however, we hope they will promote standardisation of patient assessment and care, particularly of critically unwell individuals, in whom morbidity and mortality remains unacceptably high.