通过通过被动临床决策支持来取代繁重的中断警报来解决警报疲劳问题
Anne Fallon1, Kristina Haralambides2, Justin Mazzillo3
1Division of Pediatric Hospital Medicine, Department of Pediatrics, University of Rochester Medical Center, Rochester, New York, United States.
为了减少电子健康记录警报疲劳,这项研究用被动系统取代了破坏性COVID-19警报. 这通过减少警报负担和加强及时的感染预防命令,提高了患者安全和临床医生的福祉.
科学领域:
- 医疗信息学 医疗信息学
- 临床决策支持系统 临床决策支持系统
- 患者安全 患者安全
背景情况:
- 电子健康记录 (EHR) 临床决策支持 (CDS) 的警报疲劳影响患者安全和临床医生的福祉.
- 断断续续的警报需要仔细评估,以确保临床结果,并尽量减少临床医生的负担.
- 这项研究解决了针对2019年冠状病毒病 (COVID) 预防措施的有问题的EHR警报,开发了一个被动的CDS替代方案.
研究的目的:
- 通过重新设计CDS以与最佳实践保持一致来减少警报负担.
- 提高潜在的COVID症状的入院患者的适当和及时的感染预防命令的速度.
主要方法:
- 实施了对CDS设计的代变化,包括警报触发器和确认原因.
- 为急性护理机构开发了一个非中断的,基于规则的订单小组.
- 使用控制图表来监控随时间推移的警报负担和预防措施的顺序遵守.
主要成果:
- 每周的COVID警报从8206个减少到1449个 (下降80%).
- 每次遭遇的警报率从0.36降至0.07 (下降80%).
- 对有症状患者的适当COVID预防措施订单从23%增加到61%,并减少订单时间.
结论:
- 临床决策支持 (CDS) 治理和利益相关方的合作导致了成功的警报替换.
- 一个代的设计过程导致了一个不那么繁的被动CDS系统.
- 新系统改善了订购COVID预防措施的及时性,提高了患者护理.
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