自动警报对退院阿片类药物过度处方在整体外科手术后的影响
Elsie Rizk1,2, Navjot Kaur1,2, Phuong Y Duong1,2
1Departments of Pharmacy and Surgery, Houston Methodist Hospital, Houston, TX.
概括
电子健康记录 (EHR) 警报显著减少了手术后阿片类药物过度处方. 这项质量改进倡议使通用手术患者的阿片类药物过度处方率从48%降至3%.
科学领域:
- 手术 手术 手术 术 术
- 药理学 药理学是指药理学的学科.
- 医疗信息学 医疗信息学
背景情况:
- 手术后过度处方阿片类药物是一个重大的公共卫生问题.
- 识别具有高过度处方率的外科手术对于有针对性的干预至关重要.
研究的目的:
- 为了识别出处置阿片类药物过度处方率最高的外科手术程序.
- 实施和评估电子健康记录 (EHR) 警报系统,以减少整体手术后的阿片类药物过度处方.
主要方法:
- 在一个学术医疗中心进行了一项质量改善前后研究.
- 包括接受了腹腔镜胆囊切除术,单边开放的 inguinal 修复或腹腔镜尾切除术的患者.
- 实施了EHR警报,以通知提供者超过指南建议的阿片类药物数量.
主要成果:
- 在实施了EHR警报后,退院阿片类药物过度处方从48%降至3% (P < 0.001).
- 出院时的平均阿片类药物供应从92个MME减少到57个MME (P < 0.001).
- 在出院后14天内,在额外的阿片类药物处方率中没有观察到显著的变化 (P = 0.76).
结论:
- 实施EHR预警系统,结合提供者教育,有效地减少了在整体外科中处方阿片类药物的过度处方.
- 这种干预表明了优化手术后阿片类药物处方实践的成功策略.
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