在技术变革中的药物安全:可用性评估以告知住院护士的电子健康记录系统过渡
Carrie Reale1, Deborah A Ariosto2, Matthew B Weinger3,4
1Center for Research and Innovation in Systems Safety, Department of Anesthesiology, Institute for Medicine and Public Health, and the Center for Health Services Research, Vanderbilt University Medical Center, Nashville, TN, USA. carrie.reale@vumc.org.
Journal of general internal medicine
|October 5, 2023
概括
电子健康记录系统的过渡是复杂的. 对条码药物管理 (BCMA) 系统的基于模拟的可用性测试确定了关键风险,并在系统更改期间显示出错误和任务时间的减少.
科学领域:
- 医疗信息学 医疗信息学
- 患者安全 患者安全
- 人与计算机的交互
背景情况:
- 电子健康记录 (EHR) 系统的过渡给医疗机构带来了重大挑战.
- 在大批量,安全关键的过渡过程中缺乏确保安全的标准化方法,例如条形码药物管理 (BCMA).
研究的目的:
- 在BCMA系统过渡期间识别常见和容易出现问题的药物任务中的风险.
- 为未来的系统变化建立基准,并为安全过渡提供信息.
主要方法:
- 基于模拟的可用性测试与使用传统 (R1) 和新的 (R2,R3) BCMA系统的员工护士进行.
- 任务包括药物管理,静脉输液,PRN疼痛,胰岛素,停机程序和消息传递.
- 对时间,导航和错误进行了性能分析;使用可用性和满意度使用系统可用性量表进行了测量;收集了定性反.
主要成果:
- 输液流体任务的成功率显著增加 (17%至100%),而停机时间/PRN任务的成功率则下降 (92%至22%).
- 在完成所有轮次的护士中,与安全相关的总体错误减少了53% (R1-R3) 和50% (R2-R3).
- 成功任务的平均任务完成时间减少了22% (R1-R3) 和38% (R2-R3).
结论:
- 基于模拟的可用性测试可以有效地识别BCMA系统过渡期间的潜在问题.
- 这种方法可以建立监测和评估系统变化的基准,以提高患者安全.
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