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临床决策支持工具对于识别败血症风险有用
Theresa Heineman1, Cary Orrick, Teresa K Phan
1At the University of Texas Southwestern Medical Center in Dallas, Tx., Theresa Heineman is a rapid response RN, Cary Orrick is a performance improvement coordinator with the Office of Quality and Operational Excellence, Teresa K. Phan is a research manager, Linda Denke is a nurse scientist, Folefac Atem is an adjunct associate professor, and Keri Draganic is an NP with the Cardiovascular and Thoracic Surgery Department.
临床决策支持工具 (CDST),如POC顾问 (POCA) 和修改早期预警系统 (MEWS) 在败血症识别中表现出不同的有效性. 虽然POCA减少了反应时间,但护理判断对于及时治疗败血症至关重要.
科学领域:
- 医疗信息学 医疗信息学
- 临床败血症管理管理
- 改善医疗保健质量 改善医疗保健质量
背景情况:
- 败血症仍然是导致死亡的主要原因,需要早期检测和干预.
- 临床决策支持工具 (CDST) 越来越多地用于帮助毒症识别.
- 对比不同CDST的疗效对于优化患者护理途径至关重要.
研究的目的:
- 评估POC顾问 (POCA) 和修改早期预警系统 (MEWS) 在识别住院患者败血症风险方面的有效性.
- 为了比较POCA和MEWS预警机制及时对败血症治疗的影响.
- 评估CDSTs在影响败血症管理和患者结果方面的作用.
主要方法:
- 来自两个学术医疗中心 (2020) 的成年住院患者数据的回顾性分析.
- 包括标准:与败血症相关的ICD-10代码,抗生素的使用,败血症实验室.
- 统计分析包括费舍尔的精确测试和威尔科克森的排列和值测试,以比较组和死亡率.
主要成果:
- 在744名患者中发现了143例败血症事件; 83%的患者接受了治疗预警.
- 与MEWS相比,POC顾问 (POCA) 预警组的反应时间缩短.
- MEWS组经历了更长的治疗时间;一些败血症事件被两种系统都错过了.
结论:
- CDSTs有助于败血症管理,但临床判断和护理评估至关重要.
- 来自CDST的高预警量可能导致报警疲劳.
- 将CDST与临床专业知识相结合的协作方法对于迅速治疗败血症和降低死亡率至关重要.
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