电子提醒在增加手术后增强恢复的有效性 在重大乳腺手术期间使用手术协议:前性队列研究
Sumeet Gopwani1, Ehab Bahrun2, Tanvee Singh2
1Department of Anesthesiology, MedStar Georgetown University Hospital, Washington, DC, United States.
JMIR perioperative medicine
|November 3, 2023
概括
电子通报显著改善了对乳腺手术进行增强后恢复 (ERAS) 协议的遵守. 虽然整体坚持增加了,但二次患者的结果没有显示出显著的差异.
科学领域:
- 麻醉学 麻醉学
- 手术护理 手术护理
- 医疗信息学 医疗信息学
背景情况:
- 手术后增强恢复 (ERAS) 协议是基于证据的指导方针,以优化手术患者的管理和恢复.
- 麻醉提供者利用ERAS协议来标准化麻醉计划并减少并发症.
- 目前对ERAS协议的遵守在许多临床环境中仍然低于最佳水平.
研究的目的:
- 评估电子通报系统对麻醉提供者遵守乳腺手术ERAS协议的影响.
- 确定自动提醒是否可以改善已建立但未充分使用的ERAS指南的实施.
- 研究临床决策支持系统在加强协议遵守方面的潜力.
主要方法:
- 一个单一中心前性队列研究于2017年10月至2018年8月进行.
- 确定了主要乳腺手术病例的麻醉提供者.
- 实施了电子通知系统,在手术前一晚发送关于ERAS协议的电子邮件提醒,并收集了手术前和后的数据.
主要成果:
- 在实施电子通知后,ERAS协议的整体遵守率从16%大幅增加到44% (P<.001).
- 在手术前使用 gabapentin 和 celebrex 显示了显著增加的坚持.
- 在使用斯科波胺,胺或乙氨基方面没有观察到统计学上显著的差异,也没有观察到疼痛或停留时间等次要结果.
结论:
- 自动化电子通知可以显著改善麻醉提供者对乳腺手术ERAS协议的遵守.
- 虽然协议遵守情况有所改善,但这并没有转化为研究的二次患者结果的显著变化.
- 诸如自动通知之类的技术解决方案是提高人们对外科手术期间协议的认识和遵守的可行策略.
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