开发和评估触发工具,以识别儿科血液管理错误的发展和评估
Swaminathan Kandaswamy1,2, Cassandra D Josephson3,4, Margo R Rollins1,5
1Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States of America.
Blood transfusion = Trasfusione del sangue
|April 1, 2024
概括
自动触发工具可以使用电子健康记录积极检测儿科患者血液管理 (PBM) 错误. 过度输血是常见的伤害原因,突出需要改善PBM监测.
科学领域:
- 输血医学 输血医学
- 患者安全 患者安全
- 医疗信息学 医疗信息学
背景情况:
- 儿科患者血液管理 (PBM) 计划需要持续的错误监测.
- 目前的PBM程序主要使用被动监控方法.
- 需要积极监测,以改善检测PBM错误.
研究的目的:
- 开发和评估用于积极监测儿科PBM错误的自动触发工具.
- 识别和优先考虑所有输血血液制品的候选触发工具.
- 为了估计PBM错误和相关不良事件的发生率.
主要方法:
- 使用Rand-UCLA方法与专家共识识别触发因素.
- 开发了电子健康记录 (EHR) 数据的自动查询.
- 手动审查的案例和计算的积极预测值 (PPV) 用于触发工具.
主要成果:
- 确定了28种潜在的触发因素,开发了5种自动化工具 (例如,阳性患者识别,缺失辐射,过度输血).
- 订单错误的PPV在38-100%之间.
- 过量输血与被动监测无法捕捉的不良事件有关.
结论:
- 通过电子病历数据自动检测儿科PBM错误是可行的,使积极监测.
- 过度输血是儿科患者的重大危害原因之一.
- 积极监测系统对于提高儿科患者安全至关重要.
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