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在婴儿中早期引入花生:改善 EMR 标准化指南的遵守
Lauren E Herlihy1, Elizabeth M Walters2, Jennifer P D'Auria1
1University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Pediatrics
|October 24, 2023
概括
在初级保健中实施临床决策支持工具显著改善了早期引入花生 (EPI) 的指导和婴儿花生消费,帮助预防花生过敏的努力.
科学领域:
- 儿科过敏和免疫学
- 公共卫生 公共卫生
- 医疗信息学 医疗信息学
背景情况:
- 花生过敏是儿童的重大公共卫生问题.
- 早期介绍花生 (EPI) 已被证明可以减少过敏的发展.
- 初级保健提供者经常不遵守EPI指南.
研究的目的:
- 加强对初级保健中早期引入花生指南的遵守.
- 在电子病历 (EMR) 中实施一组临床决策支持 (CDS) 工具.
主要方法:
- 采用了质量改进方法.
- 为4,6个月和9个月的健康儿童检查 (WCC) 接触开发了标准化的工作协议和CDS工具.
- 计划-做-研究-行动周期和统计过程控制图表被用于分析.
主要成果:
- 在12个月内,EPI指导的EMR文档从13.9%增加到83.5%.
- 提供商采用CDS工具的比例上升至73%,分发小册子的比例达到54.1%.
- 照顾者报告的花生摄入量从0%增加到34.6%,但没有影响疫苗接种率或访问时间.
结论:
- 质量改善举措有效地提高了EPI指南的遵守率和花生摄入量.
- 捆绑的CDS工具和EMR标准化对广泛的花生过敏预防有希望.
- 常规的WCC会议是促进EPI的可行环境.
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