实施商业电子预警系统对住院患者结果的影响
Siddhartha Singh1,2,3, Purushottam W Laud1, Bradley H Crotty1,2,3
1Collaborative for Healthcare Delivery Sciences, Medical College of Wisconsin, Milwaukee, WI.
概括
早期预警系统 (EWS) 在大型学术医疗中心没有显著改善患者的死亡率或快速响应呼叫等结果. 需要进一步的研究来确认EWS在临床实践中的有效性.
科学领域:
- 医疗信息学 医疗信息学
- 临床系统 临床系统
- 患者安全 患者安全
背景情况:
- 医院越来越多地采用早期预警系统 (EWS) 来检测患者的病情恶化.
- 然而,证明改善患者结果的确证据仍然有限.
- 商用EWS的有效性需要严格的评估.
研究的目的:
- 评估商业上可用的EWS对患者结果的影响.
- 评估住院患者死亡率的变化,快速响应小组的呼叫和心肺停止激活.
- 确定EWS的实施是否会导致患者安全的显著改善.
主要方法:
- 在一个拥有700张床位的学术医疗中心使用了前后准实验设计.
- 实施了电子医疗记录中可见的风险分数和重症监护护士远程监控的EWS.
- 调整了患者人口统计和疾病严重程度的回归不连续性分析,包括53,229次住院治疗.
主要成果:
- 在EWS实施后,没有观察到住院患者死亡率的显著变化.
- 快速响应团队的呼叫没有显著减少.
- 心肺骤停 (代码-4) 响应组的激活也没有显著的变化.
结论:
- 这种特定的EWS的实施并没有导致关键患者结局的显著改善.
- 这项研究加强了关于EWSs临床有效性的持续不确定性.
- 进一步严格的研究是必不可少的,以澄清EWS在改善患者护理中的作用和影响.
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