对于胃肠道面板测试的临床决策支持
Nadia T Saif1, Cara Dooley1, Jonathan D Baghdadi1
1Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA.
临床决策支持 (CDS) 减少了胃肠 (GI) 面板测试和与药或腹有关的不适当的订单. 然而,GI面板的整体不适当排序仍然很高,这表明需要持续的诊断管理.
科学领域:
- 医疗信息学 医疗信息学
- 临床诊断 临床诊断 临床诊断
- 医疗保健服务研究 医疗服务研究
背景情况:
- 多重肠道聚合酶连锁反应 (PCR) 测试面板 (GI面板) 是有价值的诊断工具.
- 适当的GI面板排序对于有效的患者护理和资源管理至关重要.
- 集成到电子病历 (EMR) 中的临床决策支持 (CDS) 系统可以指导诊断测试订单.
研究的目的:
- 评估CDS干预措施在改善GI面板适当排序方面的有效性.
- 评估CDS对GI面板测试的利用和适当性的影响.
主要方法:
- 一个单一中心,回顾性,前后研究在第三级护理退伍军人事务医疗中心进行.
- 在EMR中实施了一个带有"软停止"提醒的CDS工具,以提示提供商对GI面板订单的五个适当性标准.
- 分析了2022年6月至2022年11月和2023年11月至2023年4月实施CDS之前和之后用GI面板测试的患者的数据.
主要成果:
- 实施后观察到,GI面板测试的总数显著减少 (IRR 0.61,p=0.003).
- 由于药使用或未经记录的腹而导致不适当的排序,干预后显著减少 (IRR分别为0.37,p=0.012和IRR0.25,p=0.08).
- 总体而言,不合适的订单率和结果措施在实施前后期间之间没有显著差异.
结论:
- 实施CDS有效地减少了GI面板测试和特定类型的不适当订单.
- 尽管某些不合适的订单减少了,但整体上不合适的GI面板订单仍然很高.
- 持续的诊断管理工作是必要的,以优化GI面板测试的使用.
更多相关视频
05:50Author Spotlight: Point-of-Care Ultrasound for Gastric Content Assessment and Risk Stratification in Perioperative Care
Published on: September 22, 2023
06:28E-Patient Counseling Trial E-PACO: Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
相关概念视频
Serum Laboratory Studies, Stool Test, Breath Test
Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
Assessment of the Gastrointestinal System I: Subjective Data
Health History
The initial step in assessing the GI system is obtaining a comprehensive health history. This includes inquiring about the patient's history or presence of problems...
Chronic Pancreatitis II: Collaborative Care
Assessment:
Lower GI Series: Barium Enema
Procedure Details
The examination begins by inserting a lubricated rectal tube into the patient's rectum to administer a radiopaque barium solution. The barium flow is carefully...
