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卡普里尼模型集成到电子医疗记录中,以改善外科手术期间静脉血栓塞栓症的预防
Sraavya Akella1, Douglas Russo, Catherine S Bradley
1University of Iowa Hospitals and Clinics, Iowa City, Iowa.
Obstetrics and gynecology
|October 5, 2023
概括
将Caprini风险评估模型 (RAM) 集成到电子病历 (EMR) 中,显著改善了妇科手术患者的静脉血栓塞栓症 (VTE) 适当的化疗预防. 这种质量提高提高了患者的安全性,而不会增加出血风险.
科学领域:
- 医疗质量改善 改善医疗质量
- 外科手术的安全性
- 药理学预防 药理学预防
背景情况:
- 静脉血栓塞栓症 (VTE) 仍然是接受重大选择性nononcologic妇科手术的患者的重大风险.
- 适当的外科静脉瘤化学预防对于减轻这种风险至关重要.
- 目前的VTE预防策略可能无法一致应用,需要改进风险分层和实施.
研究的目的:
- 评估将Caprini风险评估模型 (RAM) 整合到电子病历 (EMR) 中对适当使用静脉瘤化疗的影响.
- 评估这种整合是否会导致推的静脉瘤预防治疗的显著增加.
- 确定改善的预防措施是否会影响患者的安全结果,例如出血事件.
主要方法:
- 追溯队列研究设计,比较两组接受重大选择性nononcologic妇科手术的患者.
- 一组在卡普里尼RAM集成到EMR之前接受了护理 (卡普里尼前-RAM组).
- 第二组在卡普里尼RAM集成到EMR后 (卡普里尼后RAM组) 接受了护理.
- 样本大小计算为每组83名患者 (共166人),80%的检测能力可以检测到适当预防的20%增加.
主要成果:
- 适当的VTE化疗预防的使用从卡普里尼前RAM组的28.9%增加到卡普里尼后RAM组的47.0% (P = .016).
- 将Caprini RAM集成到EMR中显著改善了适当的VTE预防的管理.
- 两组之间没有观察到出血事件,需要输血或其他二次安全结果的显著差异.
结论:
- 将Caprini RAM集成到EMR系统中是一种有效的策略,可以增强在接受重大非瘤性妇科手术的患者中适当使用VTE化疗预防.
- 这项质量改善计划可以通过确保适当的VTE风险管理来提高患者的安全.
- 该研究表明,在临床工作流程中,改善遵守基于证据的预防准则的成功模式.
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