Implementing Pediatric Patient Safety Practices

儿童健康责任倡议（CHA 1）是一个儿科多站点合作项目， 目标是设计、评价和执行国家儿童质量和健康成果措施。CHAI以改善美国儿童医疗保健为愿景，致力于疼痛管理、药物安全和患者安全。CHAI是第一个将基于成人的健康护理改善研究所（till）触发方法应用于儿科人群，以识别药物不良事件（ADE），并正在努力将儿科重点ADE触发因素整合到计算机化订单输入（CPOE）中。为了进一步推动减少用药错误的积极方法，CHAI最近完成了儿科特定用药规则集的开发，描述了剂量标准化和订购指南。这些规则集可以作为综合CPOE系统的一部分集成到自动化系统中。计划做出更多努力，以适应各种AHRQ患者安全实践，从“使医疗保健更安全：对患者安全实践的批判性分析”报告。这些包括在药物安全领域的进一步工作，但也包括疼痛管理以及参与CHAI的医院优先考虑的关键患者安全实践。疼痛管理最佳实践将采取教育家庭、工作人员和患者疼痛预期的方法;将实施和测试药理学和非药理学干预措施以改善疼痛;并将继续确定医院如何评估疼痛。患者安全倡议将利用重点小组的方法来确定和实施AHRQ患者安全最佳实践的五个选定领域的儿科应用，作为快速将研究推广到实践中的一种方法。根据AHRQ患者安全实践报告，计划了额外的患者安全快速周期改善项目，用于急性腹痛患者的机构间和机构内患者转移和疼痛管理。利用该领域已有的证据，CHAt正在请求AHRQ质量合作伙伴关系资助计划和支持我们的减少用药错误计划的扩展;确定并合作儿科疼痛管理的最佳实践;并评估和具体实施AHRQ患者安全最佳实践的儿科应用。

The Child Health Accountability Initiative (CHA1), a pediatric multi-site collaborative, has a primary objective to design, evaluate, and implement national measures of quality and health outcomes for children. Armed with the vision to improve the health care of America's children, CHAI is focusing its efforts on pain management, medication safety, and patient safety. CHAI is first to apply the adult-based Institute for Heaithcare improvement (till) trigger methodology to the pediatric population to identify adverse drug events (ADEs) and is working to integrate pediatric focused ADE triggers into computerized order entry (CPOE). To further drive a proactive approach to medication error reduction, CHAI has recentty completed development of pediatric specific medication rules sets describing dose standardization and ordering guidelines. These rules sets can be integrated into automation systems as part of a comprehensive CPOE system. Additional efforts are planned to adapt a variety of AHRQ patient safety practices from the "Making Health Care Safer: A Critical Analysis of Patient Safety Practices" report. These include further work in the realm of medication safety but also include pain management and as well as key patient safety practices prioritized by the hospitals participating in CHAI. Pain management best practices will take the approach of educating family, staff, and patients as to pain expectations; wilt implement and test pharmacological and non-pharmacologic interventions to improve pain; and witt continue to determine how hospitals are assessing pain. Patient safety initiatives witl utilize a focused group approach to identify and implement pediatric applications for five selected areas of AHRQ Patient Safety Best Practices as one approach to rapidly spread research into practice. Additional patient safety rapid-cycle improvement projects are planned based on the AHRQ Patient Safety Practices Report rotated to inter and intra-facitity patient transfer and pain management for patients with acute abdominal pain. Using evidence already in the field, CHAt is requesting AHRQ Partnerships for Quality funding to plan and support the expansion of our medication error reduction program; to identify and collaborate on best practices in pediatric pain management; and to evaluate and specifically implement pediatric applications of AHRQ Patient Safety Best Practices.