数字早期预警评分对医院生命体征观察协议的影响 遵守:一步步的评估
David Chi-Wai Wong1, Timothy Bonnici2, Stephen Gerry3
1Leeds Institute of Health Sciences, School of Medicine, University of Leeds, Leeds, United Kingdom.
Journal of medical Internet research
|June 20, 2024
概括
一个数字早期预警分数 (EWS) 系统并没有改变病情恶化的患者的观察频率,尽管可用性很好. 这项研究发现,与纸张图表相比,数字EWS没有改善患者的治疗结果.
科学领域:
- 医疗保健信息学 医疗保健信息学
- 临床监测 临床监测
- 患者安全 患者安全
背景情况:
- 早期预警分数 (EWS) 评估患者病情恶化的风险.
- 传统的纸张图表正在被数字系统所取代.
- 关于EWS临床有效性的证据是混合的,对管理变化的数据有限.
研究的目的:
- 评估数字EWS系统是否增加了异常生命体征后患者观察频率.
- 确定数字EWS的实施是否导致了更早的临床干预.
主要方法:
- 在英国4家医院进行的一项双臂梯形研究 (2015年2月至2016年12月).
- 纸张观察图 (控制) 与数字EWS系统 (干预) 的比较.
- 主要结局:EWS ≥3后的时间到下一次观察 (TTNO);次要结局:死亡率,停留时间,ICU入院.
主要成果:
- 分析了12802个入学;数字EWS系统显示了良好的可用性 (系统可用性得分77.6).
- 平均TTNO为128分钟 (纸质) 和131分钟 (数字).
- 在TTNO (HR 0.99,P=.73) 或其他患者结局中没有显著差异.
结论:
- 数字EWS系统具有很高的可用性和集成性,而不会对临床护理产生负面影响.
- 调查结果与之前关于数字EWS改善结果的说法相矛盾.
- 未来的研究应该专注于将数字EWS与临床途径相结合,以提高患者的治疗结果.
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