评估一种行为干预措施,以减少对老年人进行外科手术期间的米达佐拉姆治疗
Scott Seki1,2, Molly Candon3,4,5, Sushila Murthy1
1Department of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
BJA open
|August 28, 2023
概括
一个电子医疗记录警报减少了老年手术患者的二使用. 这种干预措施减少了在全身麻醉期间在70岁及以上的患者中给予米达佐拉姆的时间.
科学领域:
- 麻醉学 麻醉学
- 老年医学 老年医学
- 医疗信息学 医疗信息学
背景情况:
- 老年人经常在麻醉期间接受二,这与指导方针相反.
- 外科手术期间使用二甲的干预措施还未得到充分研究.
- 指导方针建议在麻醉期间避免在老年患者中服用二.
研究的目的:
- 评估自动电子医疗记录警报在减少对接受全身麻醉的老年人进行二二胺剂的使用方面的有效性.
- 为了测试提供者面向警报会减少外科手术期间使用二的假设.
主要方法:
- 在美国学术卫生系统的5家医院进行了回顾性研究.
- 干预:提供者教育和对70岁以上的患者进行自动EMR警报.
- 差异分析分析比较米达佐拉姆在干预前和干预后的使用情况.
主要成果:
- 在干预医院,70岁以上患者的米达佐拉姆使用率从10.7%降至6.7% (p<0.001).
- 在比较医院,米达佐拉姆的使用没有显著变化 (50.0%至49.0%,p=0.24).
- 这种干预措施与老年人 (p=0.002) 的米达佐拉姆剂量减少了3.2个百分点.
结论:
- 提供者面对的EMR警报与教育相结合,可以减少老年手术患者的手术内米达佐拉姆的使用.
- 这项干预措施在70岁及以上的患者中显著降低了二甲的使用率.
- 还观察到对年轻患者护理的潜在影响.
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