从优化一个电子订单集撤回维持生命治疗的观测
Samantha Grable1,2, Scott McKeon1, Brianna Burns3
1Palliative Medicine, OhioHealth, Columbus, Ohio, USA.
Journal of palliative medicine
|February 28, 2024
概括
优化生命维持治疗 (WLST) 订单集的电子取消,提高了35.8%的利用率,并增加了入院患者死亡的时间. 执业护士是最频繁的用户,突出了先进实践提供者在终身护理中的作用.
科学领域:
- 医疗信息学 医疗信息学
- 抚慰性护理是一种缓解性护理.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 停止维持生命治疗 (WLST) 是一个复杂的过程,需要仔细管理.
- 电子订单集可以在WLST期间标准化和提高护理质量.
- 优化的WLST顺序集在以前的利用和对患者结果的影响还不清楚.
研究的目的:
- 评估使用增强电子取消维持生命治疗 (WLST) 订单集的使用情况.
- 评估订单集优化对从订单激活到住院患者死亡的时间的影响.
- 确定使用WLST顺序集的临床医生类型以及息治疗咨询的作用.
主要方法:
- 在两个12个月的时间段 (增强前和增强后) 中,医疗保健系统内的住院患者死亡的回顾性图表审查.
- 收集的数据包括订单使用率,从订单激活到死亡的时间,临床医生人口统计和息护理咨询状态.
- 多中心研究设计,包括大量接受WLST的患者队列.
主要成果:
- 在增强后的期间,WLST订单集的利用率增加了35.8%.
- 从订单激活到住院患者死亡的时间从3.7小时显著增加到4.4小时.
- 执业护士是最频繁的使用者 (39%);委屈临床医生订购WLST导致更长的生存时间 (4.5比3.9小时).
结论:
- 改进的电子WLST订单集提高了利用率并延长了死亡的时间,这表明了更好的终身护理流程.
- 先进实践提供者和非息治疗临床医生是关键用户,应该参与订单设计.
- 这些发现强调了结构化协议和息护理整合在WLST管理中的重要性.
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