メッセージ以上のもの:1,000人の"チャット"による死
Darcy Wooten1, Christian Hendrix1, Joshua Nordman1
1Division of Infectious Diseases, Department of Medicine, Washington University in St Louis School of Medicine, St. Louis, MO, USA.
まとめ
電子医療記録 (EHR) の安全な電子メッセージは,迅速なコミュニケーションを助けますが,感染症 (ID) のコンサルタントを妨げています. 明確な境界線と有意義なコミュニケーション戦略は,患者のケアと臨床医の福祉にとって不可欠です.
科学分野:
- 医療情報工学 医療情報工学
- 臨床コミュニケーションについて
- メディカル・プラクティス・マネジメント・マネジメント
背景:
- 電子医療記録 (EHR) のEpic Chatのようなセキュアな電子メッセージングシステムは,高速で非同期的なインタラクションを可能にすることで,病院のコミュニケーションに革命をもたらしました.
- しかし,大量のメッセージが伝染病 (ID) のコンサルタントに重大な課題をもたらし,注意の断片化と臨床推論の混乱につながります.
- 些細な,反復的な,または気軽に書かれたメッセージの普及は,コミュニケーションのミスと潜在的な医療法上の問題のリスクを増大します.
研究 の 目的:
- 伝染病 (ID) のコンサルタントのワークフローと患者のケアに対する普及した電子メッセージの影響を分析する.
- 改善されたコミュニケーションの実践を提唱し,臨床環境における電子メッセージの明確な境界を確立する.
- 患者の安全と臨床医の幸福を高めるために,電子通信の最適化のための戦略を特定する.
主な方法:
- EHRメッセージングを使用するIDコンサルタントが直面するコミュニケーションパターンと課題の質的分析.
- 電子メッセージのオーバーロードの影響を受ける臨床シナリオのレビュー.
- 専門家のコンセンサスとベストプラクティスに基づく実用的な戦略の開発.
主要な成果:
- 常時送信される電子メッセージは,臨床医の注意を断片化し,臨床的推論を混乱させ,患者の安全を脅かします.
- 非効率的なメッセージは,コミュニケーションのミスと医療法上の潜在的なリスクに寄与します.
- 現在の慣行は,より有意義で意図的なコミュニケーションへの文化的シフトを必要とします.
結論:
- 電子メッセージと直接コミュニケーションの明確な境界を定めることは極めて重要です.
- レスポンスバッチング,フォーカス時間の保護,メッセージングエティケットの促進などの戦略を実施することで,負の影響を軽減することができます.
- 患者のケアを最適化し,臨床医の幸福を保障するために,コミュニケーション方法の意図性は不可欠です.
関連する概念動画
02:27Nonsense-mediated mRNA Decay
The Upf proteins that carry out nonsense-mediated decay (NMD) are found in all eukaryotic organisms, including humans. Each protein has an individual role, but they need to work in collaboration. Upf1 is an ATP-dependent RNA helicase that unwinds the RNA helix. Because Upf1 can unwind any RNA, Upf2 and Upf3 are required to help Upf1 discriminate between nonsense and normal mRNAs.
Usually, Upf3 binds to an Exon Junction Complex (EJC) at mRNA splice sites. If a ribosome fully translates the mRNA,...
Usually, Upf3 binds to an Exon Junction Complex (EJC) at mRNA splice sites. If a ribosome fully translates the mRNA,...
01:30Overview of Cell Death
Cell death is an essential process where the body gets rid of old or damaged cells. Cell proliferation and death need to be balanced, as an imbalance between the two may lead to cancer or autoimmune diseases.
Cell death was observed in the early 19th century, but there was no experimental evidence to prove it. In 1842, Carl Vogt first discovered cell death in a metamorphic toad; however, it was not termed ‘cell death.’ Scientists discovered different cell death pathways only in the 20th century...
Cell death was observed in the early 19th century, but there was no experimental evidence to prove it. In 1842, Carl Vogt first discovered cell death in a metamorphic toad; however, it was not termed ‘cell death.’ Scientists discovered different cell death pathways only in the 20th century...
01:17Phagocytosis of Apoptotic Cells
Cells undergoing apoptosis form apoptotic bodies that must be removed immediately to prevent inflammation, autoimmune diseases, and necrosis. Phagocytosis is carried out by professional phagocytes such as macrophages or immature dendritic cells. Non-professional phagocytes such as epithelial cells and fibroblasts also take part in this process; however, they are not as effective as professional phagocytes.
Normal cells contain receptors that prevent them from being recognized by phagocytes.
Normal cells contain receptors that prevent them from being recognized by phagocytes.
01:18Autophagic Cell Death
Christian de Duve discovered “autophagy,” a process in which cellular components are engulfed by membrane-bound organelles called autophagosomes. The autophagosomes then fuse with lysosomes to digest the enclosed contents. Autophagy is generally activated in cells to prevent cell death. However, cell death is triggered when the damage is beyond repair.
Autophagy and Apoptosis
Autophagy can activate apoptosis. In normal conditions, the autophagy activating protein Beclin-1 and pro-apoptotic...
Autophagy and Apoptosis
Autophagy can activate apoptosis. In normal conditions, the autophagy activating protein Beclin-1 and pro-apoptotic...
01:16Necrosis
Necrosis is considered as an “accidental” or unexpected form of cell death that ends in cell lysis. The first noticeable mention of “necrosis” was in 1859 when Rudolf Virchow used this term to describe advanced tissue breakdown in his compilation titled “Cell Pathology”.
Morphological Manifestations of Necrosis
Necrotic cells show different types of morphological appearance depending on the type of tissue and infection. In coagulative necrosis, cells become anucleated and die, but their...
Morphological Manifestations of Necrosis
Necrotic cells show different types of morphological appearance depending on the type of tissue and infection. In coagulative necrosis, cells become anucleated and die, but their...
02:27Nonsense-mediated mRNA Decay
The Upf proteins that carry out nonsense-mediated decay (NMD) are found in all eukaryotic organisms, including humans. Each protein has an individual role, but they need to work in collaboration. Upf1 is an ATP-dependent RNA helicase that unwinds the RNA helix. Because Upf1 can unwind any RNA, Upf2 and Upf3 are required to help Upf1 discriminate between nonsense and normal mRNAs.
Usually, Upf3 binds to an Exon Junction Complex (EJC) at mRNA splice sites. If a ribosome fully translates the mRNA,...
Usually, Upf3 binds to an Exon Junction Complex (EJC) at mRNA splice sites. If a ribosome fully translates the mRNA,...