在阿片类药物安全警报中选择架构
James Hellewell1, Kevin Lindsay1, Kellyann Nielsen1
1Intermountain Health, Salt Lake City, UT.
AMIA ... Annual Symposium proceedings. AMIA Symposium
|January 15, 2024
概括
在电子健康记录 (EHR) 的临床决策支持 (CDS) 中实施选择架构改善了阿片类药物处方的纳洛处方率. 这一战略提高了CDS的有效性,并减少了警报疲劳.
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
- 公共卫生干预 公共卫生干预
背景情况:
- 越来越需要有效的临床决策支持 (CDS) 集成到电子健康记录 (EHR) 中.
- 选择架构设计策略显示了提高CDS有效性的潜力.
- 预防阿片类药物过量服用需要改进处方实践,包括纳洛联合处方.
研究的目的:
- 评估实施具有选择架构的阿片类药物风险警报对纳洛处方率的影响.
- 在CDS警报中评估不同选择架构设计 (选择与主动选择) 的有效性.
- 确定对CDS警报的修订是否可以减少警报量,同时改善结果.
主要方法:
- 在EHR系统中实施阿片类药物风险警报.
- 在最初的警报中使用了选择选择的架构,推纳洛.
- 在随后的实施阶段修改了对主动选择设计的警报.
- 随着时间的推移,监控纳洛处方率和警报量.
- 在实施警报的同时,开展了教育活动.
主要成果:
- 在第一个警报版本后,阿片类药物处方与同时处方纳洛的百分比显著增加.
- 在实施第二个 (主动选择) 警报版本后,纳洛联合处方率进一步显著增加.
- 在研究期间,总体警报量大幅下降.
- 教育活动可能有助于观察到纳洛处方的改善.
结论:
- 选择架构,特别是主动选择设计,是改善CDS警报结果的有效策略.
- 修改CDS警报设计可以提高药物安全性 (纳洛处方) 并减少警报疲劳.
- 将行为设计原则集成到EHR警报中可以优化临床工作流程和患者安全.
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