优化中断性临床决策支持警报,用于在医院处方抗血栓药物重复处方
Milan Sundermann1, Olivia Clendon2, Richard McNeill1
1Department of Medicine, University of Otago, Christchurch, New Zealand.
International journal of medical informatics
|March 22, 2024
概括
排除抗血栓药物复制处方警报中的统计剂量处方,减少了29%的警报负担,并改善了处方者遵守. 这一变化凸显了临床决策支持系统中定制警报的重要性.
科学领域:
- 临床信息学 临床信息学
- 药物监督 药物监督 药物监督
- 医疗信息学 医疗信息学
背景情况:
- 重复处方警报对于防止错误至关重要,但有助于警报疲劳.
- 统计剂量处方是取代这些警报的常见原因,可能导致错过的错误.
- 警觉疲劳可以降低临床决策支持系统的有效性.
研究的目的:
- 评估从抗血栓双重处方预警中排除统计剂量处方的影响.
- 评估警报负担的变化,处方者遵守和处方模式.
- 确定修改警报设置是否可以在不影响安全的情况下减少警报疲劳.
主要方法:
- 采用了前后研究设计,分析了2017年1月至2023年9月的数据.
- 收集和分析了抗血栓药物的预警和处方数据.
- 警报负担以每100处方的警报来衡量;在警报和警报后停止时评估了遵守.
主要成果:
- 重构警报使整体警报率降低了29% (p < 0.001).
- 导致抗血栓复制停止的警报比例显著增加 (32.8%至44.5%,p < 0.001).
- 在警报点和一个小时内,坚持表现显著改善.
结论:
- 从重复处方警报中排除统计剂量处方有效地减少了警报负担.
- 这种重新配置导致了处方者对抗血栓药物警告的遵守程度增加.
- 报警后戒烟数据对于准确评估处方者遵守临床决策支持警报至关重要.
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