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首页> 外文期刊>Quality & safety in health care >Implementation of proven interventions in general medical inpatients: development and evaluation of a new quality indicator for drug therapy.
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Implementation of proven interventions in general medical inpatients: development and evaluation of a new quality indicator for drug therapy.

机译：在普通医疗住院患者中实施行之有效的干预措施：药物治疗新质量指标的开发和评估。

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BACKGROUND: Among adult general medical inpatients, there are numerous interventions whose benefits outweigh their risks. However, there are no published reports describing the overall use of such proven interventions in this population. OBJECTIVES: To determine implementation rates of a broad range of interventions while accounting for valid reasons for non-use, predictors of implementation and feasibility of generating new indices to describe quality of care. METHODS: Based on a review of current practice guidelines and clinical trials related to five common conditions, implementation rates of 17 interventions were assessed retrospectively. Subjects were a complete sample of 150 adults with target medical conditions discharged from general medical units at an urban community hospital. RESULTS: The Ideal Intervention Index (3I), which described the proportion of ideal intervention opportunities that were implemented, was 0.74 (95% CI 0.70 to 0.78). The Justified Non-Use Index (JNUI), which described the proportion of all the interventions not implemented that were justified by a valid reason for non-use, was 0.49 (95% CI 0.41 to 0.55). Smoking cessation therapy in high-risk patients had the lowest indices (3I 0.30, 95% CI 0.00 to 0.60; JNUI 0.00), and aspirin for secondary stroke prevention had the highest (3I 1.0; JNUI 1.0). CONCLUSIONS: Overall, proven interventions are underused among the patients studied, and the reasons for non-use are frequently not readily discernible. There is potential for improvement, but research is required to further investigate reasons for non-use. It is feasible to measure implementation rates of proven interventions as an indicator of quality of care using the indices developed.
机译：背景：在成人普通内科住院病人中，有许多干预措施的益处大于其风险。但是，没有公开的报告描述这种已证实的干预措施在该人群中的总体使用。目标：确定广泛的干预措施的实施率，同时考虑不使用的正当理由，实施的预测因素以及生成描述护理质量的新指标的可行性。方法：基于对当前实践指南的回顾和与五种常见病症相关的临床试验，对17项干预措施的实施率进行回顾性评估。受试者是150名成年人的完整样本，这些成年人的目标医疗状况是从城市社区医院的普通医疗机构出院的。结果：描述了实施的理想干预机会比例的理想干预指数（3I）为0.74（95％CI为0.70至0.78）。合理的不使用指数（JNUI）为0.49（95％CI为0.41至0.55），该指数描述了所有因未使用的正当理由而被实施的干预措施所占的比例。高危患者的戒烟治疗指数最低（3I为0.30，95％CI为0.00至0.60; JNUI为0.00），而阿司匹林用于继发性卒中的预防最高（3I 1.0; JNUI 1.0）。结论：总体而言，在研究的患者中未使用有效的干预措施，并且不使用的原因通常不容易理解。有改进的潜力，但需要进行研究以进一步调查不使用的原因。使用开发的指标来衡量已证明干预措施的实施率，作为护理质量的指标是可行的。

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