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首页> 外文期刊>Journal of pediatric oncology nursing: official journal of the Association of Pediatric Oncology Nurses >Increasing Activities of Daily Living Is as Easy as 1-2-3
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Increasing Activities of Daily Living Is as Easy as 1-2-3

机译：增加日常生活的活动就像1-2-3一样容易

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Background: Human flora are the most common cause of bacteremia in immunocompromised patients. Activities of daily living (ADL), including oral care and daily chlorhexidine gluconate bathing, can lower the risk of infection. Methods: To address ADL compliance in our pediatric oncology and bone marrow transplant patients, we adopted the ADL 1-2-3 initiative: daily chlorhexidine gluconate bath and linen change, at least 2 activities per day, and oral care 3 times per day. Using the Model for Improvement we created a standardized ADL process that involved all providers. Interventions included addressing ADL 1-2-3 compliance during rounds, establishing accountability in care delivery, an oral care order set and algorithm, daily text message reminders, and physician intervention with noncompliant and high-risk patients. Results: With our interventions, we increased our median compliance with the all-or-none ADL 1-2-3 initiative from 25% to 66% in 90 days. We have sustained our median compliance to 75% sixteen months after implementation. The greatest impact on compliance was seen with text message reminders to staff to complete and document the ADL 1-2-3 components, designated roles and responsibilities, and physician discussion with noncompliant and high-risk patients. Discussion: Oral care algorithm and order set, daily text message reminders, and physician intervention with noncompliant and high-risk patients has improved our compliance. Units where compliance with ADL participation is low can benefit from incorporating elements from this ADL 1-2-3 initiative.
机译：背景：人类菌群是免疫功能低下患者中菌血症的最常见原因。日常生活活动（ADL），包括口腔护理和每日葡萄糖酸氯己定的沐浴，可以降低感染的风险。方法：为了解决我们的儿科肿瘤和骨髓移植患者的ADL依从性，我们采用了ADL 1-2-3计划：每天换洗葡萄糖酸洗必泰和亚麻，每天至少进行2次活动，每天进行3次口腔护理。使用改进模型，我们创建了一个涉及所有提供商的标准化ADL流程。干预措施包括解决各回合中ADL 1-2-3的依从性，建立护理交付的责任制，口腔护理命令集和算法，每日短信提醒以及医师对不依从和高风险患者的干预。结果：通过我们的干预，我们在90天内将对全部或没有ADL 1-2-3计划的依从性的中位数从25％提高到66％。实施后的16个月，我们已将中位数合规率维持在75％。提示员工完成和记录ADL 1-2-3组件，指定的角色和职责以及医生与不合规和高风险患者的讨论，对合规性的影响最大。讨论：口腔护理算法和命令集，每日短信提醒以及医师对不依从和高风险患者的干预提高了我们的依从性。对ADL参与度较低的单位可以从ADL 1-2-3计划的内容中受益。

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