Anaesthesia, critical care & pain medicine · 2016
Evaluation of a continuous improvement programme of enhanced recovery after caesarean delivery under neuraxial anaesthesia.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Deniau Benjamin, Bouhadjari Nacima, Faitot Valentina, Mortazavi Antoine, Kayem Gilles, Mandelbrot Laurent, Keita Hawa
Аннотация
OBJECTIVE: To assess the performance of a multidisciplinary programme for enhanced recovery after caesarean delivery under neuraxial anaesthesia.
STUDY DESIGN: Prospective single-centre study.
METHODS: Programme in 6 steps including 3 professional practice audits based on clinical records and questioning patients: audit T0, first "existing state", creation of a working group, drafting and implementation of a multidisciplinary rehabilitation procedure, second audit (T0+4 months), information about and implementation of corrective measures and a third audit (T0+8 months). Assessment of the performance of the continuous improvement programmes based on six measures comprising the post-caesarean rehabilitation score: duration infusion, early oral analgesia, time to removal of the urinary catheter, time to return to drinking, eating recovery time, use of carbetocin.
RESULTS: Two hundred and thirty-one patients were included, with 45, 64 and 122 patients at T0, T0+4 months and T0+8 months, respectively. There was a significant increase in patients who received the recovery measures (P<0.0001 for all items) between T0 and T0+8 months: removal of the infusion before 24h (49% versus 93.5%), drinking before 6h (31% versus 55%), eating before 6h (2% versus 38.5%), early oral analgesia before 24h (38% versus 95%), withdrawal of the urinary catheter before 24h (80% versus 95%), use of carbetocin (0% versus 99%).
CONCLUSION: Improved practices in rehabilitation after caesarean can be obtained by setting up a multidisciplinary programme as part of a quality approach.
STUDY DESIGN: Prospective single-centre study.
METHODS: Programme in 6 steps including 3 professional practice audits based on clinical records and questioning patients: audit T0, first "existing state", creation of a working group, drafting and implementation of a multidisciplinary rehabilitation procedure, second audit (T0+4 months), information about and implementation of corrective measures and a third audit (T0+8 months). Assessment of the performance of the continuous improvement programmes based on six measures comprising the post-caesarean rehabilitation score: duration infusion, early oral analgesia, time to removal of the urinary catheter, time to return to drinking, eating recovery time, use of carbetocin.
RESULTS: Two hundred and thirty-one patients were included, with 45, 64 and 122 patients at T0, T0+4 months and T0+8 months, respectively. There was a significant increase in patients who received the recovery measures (P<0.0001 for all items) between T0 and T0+8 months: removal of the infusion before 24h (49% versus 93.5%), drinking before 6h (31% versus 55%), eating before 6h (2% versus 38.5%), early oral analgesia before 24h (38% versus 95%), withdrawal of the urinary catheter before 24h (80% versus 95%), use of carbetocin (0% versus 99%).
CONCLUSION: Improved practices in rehabilitation after caesarean can be obtained by setting up a multidisciplinary programme as part of a quality approach.