改善居民遵守门诊护理标准:VA关于计算机提醒的合作研究的结果
J G Demakis1, C Beauchamp, W L Cull
1Hines VA Hospital, PO Box 5000, Hines, IL 60141, USA.
JAMA
|September 16, 2000
概括
计算机提醒系统改善了医生在多个退伍军人事务诊所的门诊护理标准的合规性. 然而,随着时间的推移,这些系统的好处逐渐减少,需要对持续有效性的进一步研究.
科学领域:
- 医疗信息学 医疗信息学
- 改善临床质量 改善临床质量
- 医学教育 医学教育
背景情况:
- 临床护理的计算机提醒系统在不同患者群体和环境中缺乏广泛的评估.
- 改善医生遵守既定护理标准对于患者的治疗结果至关重要.
研究的目的:
- 评估计算机提醒系统对住院医生遵守门诊护理标准的影响.
- 评估该系统在多个退伍军人事务 (VA) 门诊护理诊所的有效性.
主要方法:
- 这是一项随机对照试验,涉及12个VA医疗中心的275名住院医生.
- 住院人员被分配到提醒组或控制组,在17个月内照顾12989名患者.
- 通过数据库和遭遇表格,追踪了13个护理标准 (SOC) 的遵守情况.
主要成果:
- 提醒组在统计学上显著地显示出所有联合SOC (58.8%对53.5%) 和5个SOC的更高的合规率.
- 在衡量每次访问提供的护理时,提醒组也显示了所有联合SOC和9个个人SOC的显著更高的遵守率 (17.9%vs12.2%).
- 在研究期间观察到,尽管系统持续激活,但提醒的好处明显下降.
结论:
- 多站点计算机提醒系统可以提高住院医生遵守多种护理标准的程度.
- 这些提醒系统的有效性似乎随着时间的推移而下降.
- 需要进行进一步的研究,以制定维持提醒系统长期效益的策略.
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