实施增强麻醉恢复计划(EARP)以改善麻醉相关患者的护理结果并加强早期恢复。

Mukul Chandra Kapoor, Bindu Sharma
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摘要

增强麻醉恢复计划(EARP)是一项独特的以患者为中心,由麻醉师主导的质量改进计划,旨在减少术后麻醉相关并发症并加速恢复。已知麻醉相关并发症与患者预后差和较高的发病率/死亡率相关。该项目旨在制定方案,以改善麻醉恢复,从而提高患者的预后质量。根据最近的临床研究结果,对国家和国际指南进行了详细的审查,并设计了EARP路径,以纳入围手术期管理的变化,以改善患者的手术体验,确保更好的术后认知功能和降低术后发病率。项目实施后,麻醉相关患者护理结果显著改善,约6233名患者受益。PACU的中位住院时间从26分钟减少到18分钟。认知功能的早期恢复(早期恢复)是明显的,术后认知功能恢复的时间从10分钟减少到3分钟。需要补充氧气的人群比例从20%降至5%。意外气管再插管率由0.05降至0.02。术后出现恶心和呕吐的患者比例从8%降至3%。这一举措还使用于患者的麻醉剂支出减少了约50%。
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Implementation of Enhanced Anesthesia Recovery Program (EARP) for improving Anesthesia Related patient care outcomes & enhancing early recovery.

The Enhanced Anesthesia Recovery Program (EARP) is a unique patient-centered, Anesthesiologist-led quality improvement initiative designed to reduce postoperative anesthesia-related complications and to accelerate recovery. Anesthesia-related complications are known to be associated with poor patient outcomes and higher morbidity/mortality. This project was designed to develop protocols to improve anesthesia recovery and thereby the quality of patient outcomes. A detailed review of national & international guidelines was carried out and EARP pathways were designed to incorporate changes in perioperative management, as per recent clinical research findings, to improve the patient surgery experience, ensuring better postoperative cognitive function and a reduction in postoperative morbidity. Following project implementation, a remarkable improvement was seen in Anesthesia Related patient care outcomes, benefitting around 6233 patients. The median Length of Stay in PACU was reduced from 26 minutes to 18 minutes. Early Return of Cognitive Functions (Early Recovery) was evident by a reduction in the time for a post-operative return of cognitive functions, from 10 minutes to 3 minutes. The percentage of people requiring oxygen supplementation was reduced from 20% to 5%. The unplanned tracheal re-intubation Rate was reduced from 0.05 to 0.02. The percentage of patients experiencing postoperative nausea and vomiting was reduced from 8% to 3%. This initiative also resulted in about a 50% reduction in spending on anesthetic agents for patients.

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