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The Impact of Automated Electronic Surveillance of Electronic Medical Records on Pediatric Inpatient Care

Jais Emmanuel1, Adalberto Torres2

  • 1Pediatrics, University of Central Florida, Orlando, USA.

Cureus
|December 12, 2018
PubMed

Insights

Automated electronic medical record surveillance for hospitalized children shows device-associated infection alerts (CLABSI, CAUTI) prompted more clinical interventions than less-specific alerts (PEWS, neonatal sepsis). Focusing on high-yield alerts optimizes resource allocation.

Area of Science:

  • Pediatric hospital medicine
  • Clinical informatics
  • Patient safety

Background:

  • Automated electronic medical record (EMR) surveillance systems are increasingly used to monitor hospitalized patients.
  • These systems generate alerts for various clinical conditions, including infections and deterioration, aiming to improve patient care.
  • The effectiveness of these alerts in triggering timely clinical interventions varies depending on the alert type.

Purpose of the Study:

  • To evaluate the impact of automated EMR surveillance alerts on clinical interventions in hospitalized children.
  • To compare the rate of interventions triggered by different types of alerts: central line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), neonatal sepsis, and pediatric early warning scores (PEWS).

Main Methods:

  • Retrospective chart review of alerts generated by automated EMR surveillance over a five-month period.
  • Analysis included alerts for CLABSI, CAUTI, neonatal sepsis, and PEWS.
  • Fisher's exact test was used to compare intervention proportions between alert groups.

Main Results:

  • A total of 244 alerts were analyzed: 27 CAUTI, 55 CLABSI, 10 neonatal sepsis, and 152 PEWS.
  • Alerts for potential device-associated infections (CLABSI, CAUTI) resulted in significantly more interventions (24.4%) compared to neonatal sepsis and PEWS alerts (5.6%) (p<0.001).
  • Neonatal sepsis alerts triggered the fewest alerts and proportionately fewer interventions.

Conclusions:

  • Automated surveillance alerts for device-associated infections are more effective in prompting clinical interventions than less specific alerts.
  • Neonatal sepsis alerts resulted in minimal interventions, suggesting a need for refinement or different monitoring strategies.
  • Prioritizing alerts that lead to actionable interventions can improve resource allocation and potentially patient outcomes.

Keywords:
alertautomatedelectronic medical recordhospitalized childreninpatientinterventionpediatricsretrospective studysurveillance

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