减少急性呼吸道感染抗生素的处方使用一线护士领导的EHR-Integrated临床决策支持工具:一个阶段随机对照试验的协议
Elizabeth R Stevens1, Ruth Agbakoba1, Devin M Mann1
1NYU Grossman School of Medicine, New York, NY, USA.
BMC medical informatics and decision making
|November 14, 2023
概括
一名注册护士 (RN) 领导的电子健康记录集成临床预测规则 (iCPR) 可以减少急性呼吸道感染 (ARI) 的抗生素处方. 这种方法可以改善护理,减少在门诊机构不必要的抗生素使用.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 传染病管理 传染病管理
- 初级保健创新初级保健的创新
背景情况:
- 对急性呼吸道感染 (ARI) 过度处方抗生素是一个重要的门诊问题.
- 临床预测规则 (CPR) 可以制不适当的抗生素使用,但未得到充分利用.
- 一个注册护士 (RN) 领导的电子健康记录集成CPR (iCPR) 模型为医生驱动的模型障碍提供了潜在的解决方案.
研究的目的:
- 为了评估RN领导的iCPR模型用于低敏度的ARI.
- 确定RN实施iCPR是否会降低抗生素处方率.
- 评估对诊断测试订购,资源利用,成本效益,患者满意度和临床医生倦怠的影响.
主要方法:
- 将进行一个阶段式,实践级的集群随机对照试验 (RCT).
- 该研究是在iCPR工具的定性可用性测试之后进行的.
- 这项干预涉及使用iCPRs为低急性ARI患者提供RN引导的护理.
主要成果:
- 主要假设是,RN主导的iCPR工具将减少整个初级保健机构的抗生素处方.
- 二次结果包括对快速链球菌检测,胸部X射线,资源使用,成本效益,患者满意度和临床医生倦怠的影响.
结论:
- 本研究探讨了一种创新的RN主导的iCPR模型,用于打击ARI的抗生素过度处方.
- 这些发现可以指导将低急性ARI护理委托给RN,以加强iCPR的采用,并减少门诊环境中不适当的抗生素处方.
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