麻醉剂在肩膀手术中的处方实践,在麻醉剂电子处方制度建立之前和之后
Emily Kleinbart1, Haley Tornberg2, Christopher Rivera-Pintado1
1Department of Orthopaedic Surgery, Cooper University Hospital, Camden, NJ, USA.
JSES reviews, reports, and techniques
|May 6, 2024
概括
电子处方 (e-scripts) 在肩膀手术后显著降低了阿片类药物的数量. 这一策略有助于通过限制患者获得多余的止痛药来打击阿片类药物流行.
科学领域:
- 整形外科手术 整形外科手术
- 疼痛管理 疼痛管理
- 公共卫生 公共卫生
背景情况:
- 阿片类药物流行需要严格监管麻醉药物止痛药的处方.
- 通过EMR平台的电子处方 (e-scripts) 可以限制阿片类药物的剂量和数量,减少滥用潜力.
- 实施电子处方旨在控制肩膀手术后的阿片类药物处方.
研究的目的:
- 评估e-script实施对肩部手术后阿片类药物处方量的影响.
- 为了比较不同监管和技术时代处方的阿片类MME.
主要方法:
- 一个单一中心的回顾性研究分析了1857名接受肩膀手术的患者 (2015年1月至2020年12月).
- 在手术后90天内处方的阿片类MME在三个队列中进行了比较:NJ前阿片类法律,NJ后阿片类法律/预编写和后编写 (2019年7月实施).
- 排除标准包括手术前的阿片类药物,非骨科或疼痛管理医生的处方,以及同时进行的非肩膀手术.
主要成果:
- 在e-scripting实施后,总的MME显著下降 (P < .001),从90的中位数降至45.
- 在所有手术 (P < .001) 和4名外科医生中,有3名外科医生观察到阿片类药物处方的统计显著减少.
- 该研究包括796名 (新泽西州前阿片类药物法律),520名 (新泽西州后阿片类药物法律/电子书写前) 和541名 (电子书写后) 参与者.
结论:
- 电子写字的实施导致了在肩部手术中术后阿片类药物MME的显著减少.
- 电子脚本是有效的工具,补充教育和意识,打击阿片类药物流行病.
- 该战略有助于国家,机构,提供者和患者努力负责任地管理止痛药.
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