减少支气管扩展剂在支气管炎中的使用干预措施的影响 - - 时间序列分析
Joanna Lawrence1,2,3,4, Harriet Hiscock2,3, Alice Voskoboynik4
1Electronic Medical Record Team, Royal Children's Hospital, Melbourne, Australia.
一项多方面的干预措施显著减少了支气管炎婴儿的支气管扩展剂处方. 这种方法,包括电子医疗记录警报,有效地制了儿科急诊室的低价值护理.
科学领域:
- 儿科急救医学 儿科急救医学
- 医疗保健服务研究 医疗服务研究
- 改善临床质量 改善临床质量
背景情况:
- 国际指导方针建议不要在支气管炎中使用支气管扩展剂.
- 减少儿科的低价值护理仍然是一个不断变化的挑战.
- 减少低价值护理的干预措施的有效性需要进一步研究.
研究的目的:
- 评估多面干预对儿童支气管炎病例中支气管扩展剂处方率的影响.
- 评估结合教育,审计反和电子医疗记录 (EMR) 警报的有效性.
主要方法:
- 利用了来自儿科教学医院急诊室的76个月EMR数据的中断时间序列分析.
- 包括被诊断患有支气管炎的1-12个月龄的婴儿.
- 该干预措施于2019年2月实施,包括教育,临床医生审计反和EMR警报.
主要成果:
- 分析了9576名被诊断患有支气管炎的婴儿的数据.
- 干预后,支气管扩展剂的处方率从6.9%降至3.2%.
- 在统计学上,这项干预与处方率的显著降低有关 (P = .037).
结论:
- 多方面的干预,特别是结合EMR警报,可以有效地减少低价值支气管扩展剂在支气管炎的处方.
- 这一策略加速了不必要的医疗护理的减少.
- 该干预措施支持对儿科呼吸道感染的临床实践进行可持续的变化.
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