通过最佳实践咨询-可行性研究,改善灾难性中风患者获得专家息护理的机会
Vandana Nagpal1,2, Marcey L Osgood1,2, Jennifer Reidy1,2
1UMass Memorial Health, Worcester, MA, USA.
The Neurohospitalist
|July 13, 2023
概括
一个新的电子警报系统改善了息护理 (PC) 咨询中风患者. 这项干预成功地提醒医生PC需求,增加了符合条件的患者的咨询.
科学领域:
- 神经学 神经学
- 抚慰性护理是一种缓解性护理.
- 医疗信息学 医疗信息学
背景情况:
- 美国心脏协会和美国中风协会建议对中风患者提供息治疗 (PC).
- 灾难性中风需要专家的症状管理,沟通和共享决策.
- 医生提醒对于解决中风护理中PC需求至关重要.
研究的目的:
- 试行一种干预措施,提醒医生注意中风患者的息护理需求.
- 为了评估电子最佳实践咨询 (BPA) 对PC咨询的影响.
- 确定实施中风护理系统变革的障碍.
主要方法:
- 开发了一个电子医疗记录 (Epic) 最佳实践咨询 (BPA).
- 在NIHSS得分≥20的情况下,BPA建议进行护理目标对话和PC咨询.
- 评估BPA对PC咨询和供应商警报管理的影响.
主要成果:
- 在所有符合条件的中风患者中,BPA成功触发.
- 每100名患者的息护理咨询次数从11.7 (2019) 增加到20.7 (2020) 和15.6 (2021).
- 改善了BPA警报的供应商管理,在2020-2021年减少了30%以上的警报频率.
结论:
- 电子最佳实践咨询可以有效地增加中风患者的息护理咨询.
- 干预措施可以改善医生遵守息治疗建议的情况.
- 系统变化需要持续评估和提供商适应以获得最佳结果.
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