提高喘息儿童的医疗质量：电子哮喘行动计划和电子学前喘息行动计划的使用
2016/11/09
摘要
目的：在引入电子哮喘行动计划 (eAAP)之后，评估从急诊出院的哮喘和喘息的儿童使用哮喘行动计划（AAP）后的长期改善情况，并确定电子学前喘息行动计划在我们人群中的需求情况。
方法：从2014年7月到2015年6月，对12个月大以上的从急诊部或急救医疗单位出院诊断为哮喘或喘息的患者的病例记录进行回顾性调查研究。主要的结果是作为患者医疗记录的一部分的AAP的文件：电子版的eAAP或者纸质AAP报告。
结果:2342例患者被纳入研究，926例哮喘，1416例喘息。年龄中位数为3.3岁（四分位间距（IQR）3.5，范围1-15.9岁）。哮喘患儿的中位数年龄为5.3岁（IQR 4.6），喘息孩子的是2.5岁（IQR 2.0）。总体而言，1683（71.9%）位儿童有记录的AAP，并在出院诊断为哮喘（85.9%）与喘息的（62.9%）患者之间有显著差异，P < 0.001。这些结果证明电子学前喘息行动计划的设计是正确的。
结论:将电子哮喘行动计划（eAAP）融入急诊导致了将哮喘行动计划（AAP）提供给出院诊断为哮喘的儿童，这些患儿健康状况持续改进。而出院诊断为喘息的孩子则较少收到行动计划。
（苏欣 审校）
J Paediatr Child Health. 2016 Sep;52(9):872-6. doi: 10.1111/jpc.13343. Epub 2016 Sep 7.
Improving the quality of care for children with wheeze: The use of electronic asthma action plans and electronic pre-school wheeze action plans.
O'Leary F1,2, Pegiazoglou I3,4, Marshall T5, Thosar D3, Deck M3, Peat J6, Ging J7, Selvadurai H4,5.
Author information
Abstract
AIM:To measure the long-term improvement in the documented provision of an asthma action plan (AAP) to children with asthma and wheeze discharged from the Emergency Department following the introduction of the electronic AAP (eAAP) and to determine the need for an electronic pre-school wheeze action plan in our population.
METHODS:A retrospective case note review, from July 2014 to June 2015, of all patients over 12 months old discharged from the Emergency Department or Emergency Medical Unit, with a discharge diagnosis of either asthma or wheeze. The primary outcome was the documentation of an AAP, either recorded electronically as an eAAP or a report of an AAP as part of the patient medical record.
RESULTS:Two thousand three hundred and forty-two patients were included in the study, 926 with asthma and 1416 with wheeze. The median age was 3.3 years (interquartile range (IQR) 3.5, range 1-15.9 years). The median age of the children with asthma was 5.3 years (IQR 4.6) and of the children with wheeze was 2.5 years (IQR 2.0).Overall, 1683 (71.9%) children had a documented AAP, with a significant difference between those with a discharge diagnosis of asthma (85.9%) compared with wheeze (62.9%), P < 0.001. These results justified the design of the electronic pre-school wheeze action plan.
CONCLUSIONS:The integration of an eAAP into the Emergency Department has resulted in a sustained improvement in the documented provision of an AAP to children with a discharge diagnosis of asthma. Children with a discharge diagnosis of wheeze are significantly less likely to receive an action plan.
© 2016 The Authors. Journal of Paediatrics and Child Health published by John Wiley & Sons Australia, Ltd on behalf of Paediatrics and Child Health Division (The Royal Australasian College of Physicians).
KEYWORDS:asthma; child; education; pre-school; quality improvement
J Paediatr Child Health. 2016 Sep;52(9):872-6. doi: 10.1111/jpc.13343. Epub 2016 Sep 7.
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