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用户为中心的设计和临床决策支持的评估,以改善早期花生引入:形成性研究
Thinh Hoang Nguyen1,2, Priscila Pereira Cunha1, Annabelle Friedman Rowland1
1Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States.
JMIR formative research
|August 22, 2023
概括
一个新的临床决策支持 (CDS) 工具有效地改善了对初级保健中早期引入花生指南的遵守. 这种工具在健康儿童访问期间增强了对潜在的花生过敏症状的婴儿的综合护理.
科学领域:
- 儿科过敏和免疫学
- 临床信息学 临床信息学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 花生过敏的患病率正在增加,需要更新婴儿养指南.
- 早期引入花生,得到LEAP研究的支持,与以前的避免建议形成鲜明对比.
- 当前的指导方针的遵守程度不够理想,导致错过了预防和管理的机会.
研究的目的:
- 开发和评估一个以用户为中心的临床决策支持 (CDS) 工具,用于初级保健.
- 该工具旨在加强早期引入花生指南的实施.
- 改善对潜在的花生过敏的婴儿的综合护理.
主要方法:
- 集成的CDS提示和照顾点教育进入健康儿童检查 (WCC) 电子健康记录 (EHR) 笔记模板,用于4个月和6个月的访问.
- 在模拟的EHR环境中对儿科住院医生进行了形成性和总结性可用性测试.
- 通过比较带有CDS和没有CDS的电子健康记录,评估任务完成率和感知CDS工具的有用性.
主要成果:
- 形成性测试导致了CDS工具的WCC笔记模板中的代改进.
- CDS工具显著增加了关于在四个月的世卫组织访问中提前引入花生的讨论 (60%与CDS相比0%没有).
- 在六个月的世卫组织访问中,CDS指导改善了关于花生反应的综合护理,包括转诊,上腺素处方和紧急计划.
结论:
- 以用户为中心的CDS工具可以有效地改善早期花生引入指南的应用.
- 开发的CDS工具在模拟环境中增强了对患有花生过敏症状的婴儿的综合护理.
- 这种方法有望改善指导方针的遵守和初级保健中的患者结果.
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