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使用临床决策支持系统减少静脉注射乙氨基的使用:实施和经验教训
Gabriel Tse1, Claudia Algaze2, Natalie Pageler3
1Department of Pediatrics, Division of Pediatric Hospital Medicine, Stanford University School of Medicine, Stanford, California, United States.
Applied clinical informatics
|November 23, 2023
概括
在儿科医院使用IV乙氨基的中断性临床决策支持系统 (CDSS) 没有成功. 该系统没有改变使用方式,并且由于供应商接受度低和效率问题,对患者护理产生了负面影响.
科学领域:
- 医疗保健信息学 医疗保健信息学
- 改善临床质量 改善临床质量
- 儿科医院医药 儿科医院医药
背景情况:
- 临床决策支持系统 (CDSS) 为医疗决策提供了潜在的好处,但也可能导致意外的伤害.
- 它们的有效性并不普遍,需要仔细实施和评估.
研究的目的:
- 描述了一项不成功的中断性CDSS的实施,旨在优化儿科医院内静脉注射 (IV) 乙氨基的使用.
- 确定从这一实施中吸取的经验教训,重点关注最终用户的接受性和对护理的影响.
主要方法:
- 采用了质量改进方法,实施了具有24小时到期的中断性CDSS,用于IV乙氨基订单.
- 主要结局测量了每1000名患者日内IV乙氨基给药量.实施前和后.
- 过程和平衡措施包括订单率,提供者/护士的接受度,以及通过调查产生的意外后果.
主要成果:
- 在实施后或在去除CDSS后,没有观察到全医院IV乙氨基给药或订单的显著变化.
- 近一半的88名调查受访者报告了对患者护理的负面影响,理由是延迟和效率下降.
- 最终用户接受度低是CDSS缺乏成功的一个关键因素.
结论:
- 监测CDSS的实施和结合最终用户的接受度是成功的关键.
- 团队必须准备好适应或删除未能达到目标或用户接受度低的CDSS.
- 仔细实施和持续评估对于最大限度地提高CDSS的好处,并最大限度地减少临床实践中的危害至关重要.
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