促进者和障碍者与ICU中的临床决策支持互动:一种混合方法方法
Adrian Wong1, Lucas A Berenbrok2, Lauren Snader2
1Beth Israel Deaconess Medical Center, Department of Pharmacy, Boston, MA.
在ICU中的临床决策支持系统 (CDSS) 可能会导致警觉疲劳. 提高CDSS的特异性和优先级可以提高临床医生的互动和患者安全.
科学领域:
- 医疗保健信息学 医疗保健信息学
- 临床决策支持系统 临床决策支持系统
- 重症监护室 (ICU) 医学重症监护室
背景情况:
- 临床决策支持系统 (CDSS) 在医疗保健中对于改善决策,特别是在ICU中至关重要.
- 然而,低于最佳的CDSS利用导致警觉疲劳,可能会对患者造成伤害.
- 专注病房的临床医生特别容易受到警报脱敏的影响.
研究的目的:
- 评估促进者和障碍物,以适当的CDSS互动在ICU.
- 提出改善目前ICUCDSS的方法.
主要方法:
- 采用了一种连续的解释性混合方法研究设计,利用行为和接受框架 (BEAR).
- 一项国际调查与临床医生 (药剂师,医生) 进行,他们有CDSS的经验.
- 对深度访谈的定性分析进一步探索了临床医生的关于CDSS的信念和行为.
主要成果:
- 一项对48名受访者的调查表明,75%的人认为响应CDSS警报是他们的工作的一部分,但56.5%的人表示经历了警报疲劳.
- 确定了五个促进因素:患者安全,易于响应,特异性,优先级和反.
- 他们发现了四个障碍:过度的警报数量,具有挑战性的工作环境,难以响应和警报无关紧要.
结论:
- 机构必须专注于特定领域,以改善ICU中适当的CDSS互动.
- 将CDSS定制为独特的ICU环境对于提高系统有效性至关重要.
- 优化的CDSS相互作用有可能显著改善患者安全结果.
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