Quality in quality improvement research - a new benchmark 英文参考文献.docVIP

Asher and White Critical Care 2011, 15:316 /content/15/6/316 JOURNAL CLU B CRITIQUE Quality in quality improvement research - a new benchmark Nikhil R Asher* and Douglas B White 1 1,2 University of Pittsburgh Department of Critical Care Medicine: Evidence-Based Medicine Journal Club, edited by Sachin Yende Expanded abstract Main outcomes Citation e primary outcome was the summary ratio of odds Scales DC, Dainty K, Hales B, Pinto R, Fowler RA, ratios (ORs) for improvement in adoption (determined Adhikari NK, Zwarenstein M: A multifaceted inter- vention for quality improvement in a network of intensive care units: a cluster randomized trial. JAMA 2011, 305:363-72. by daily data collection) of all 6 practices during the trial in intervention vs control ICUs. Results Overall, adoption of the targeted practices was greater in Context intervention ICUs than in controls (summary ratio of Evidence-based practices improve intensive care unit ORs, 2.79; 95% con? dence interval [CI], 1.00-7.74). (ICU) outcomes, but eligible patients may not receive them. Community hospitals treat most critically ill patients Improved delivery in intervention ICUs was greatest for semi recumbent positioning to prevent ventilator-asso- but may have few resources to devote to quality ciated pneumonia (90.0% of patient-days in last month improvement. vs. 50.0% in ? rst month; OR, 6.35; 95% CI, 1.85-21.79) and precautions to prevent catheter-related bloodstream infection (70.0% of patients receiving central lines vs. Objective To determine the e? ectiveness of a multicenter quality 10.6%; OR, 30.06; 95% CI, 11.00-82.17). Adoption of improvement program to increase delivery of 6 evidence- based ICU practices. other practices, many with high baselin