临床决策支持对强制性与自愿性静脉血栓栓塞风险评估在住院患者中的影响
Vinita Bahl1, Marc J Moote2, Hsou Mei Hu3
1Department of Surgery, University of Michigan Health Michigan Medicine, Ann Arbor, Michigan, United States.
TH open : companion journal to thrombosis and haemostasis
|September 13, 2024
概括
强制性静脉血栓塞栓症 (VTE) 风险评估显著改善了预防措施的遵守,并减少了住院VTE. 然而,放出后的VTE率增加,突出了扩大预防指南的必要性.
科学领域:
- 改善医疗保健质量 改善医疗保健质量
- 临床决策支持系统 临床决策支持系统
- 患者安全 患者安全
背景情况:
- 静脉血栓栓塞 (VTE) 对住院患者构成重大,可预防的风险.
- 有效的VTE风险评估 (RA) 对于适当的预防和改善结果至关重要.
- 计算机化临床决策支持 (CDS) 可以增强VTE预防,但设计特征的影响需要研究.
研究的目的:
- 评估强制性与自愿性VTE风险评估 (RA) 对预防和结果的影响.
- 评估VTE预防的CDS实施不同阶段的有效性.
- 根据RA要求,分析住院和出院期间的VTE率.
主要方法:
- 利用中断时间序列分析来追踪四个CDS实施阶段的预防趋势.
- 使用后勤回归来比较强制性和自愿性RA期间之间的VTE发病率.
- 总体,住院和出院后VTE的计算调整的几率比率 (ORs).
主要成果:
- 在研究期间,智能订单设置推的预防从65%增加到79%.
- 与自愿阶段相比,强制性RA阶段的预防率明显高.
- 在强制性RA期间,对VTE进行调整的OR较低,主要是由于医院内事件减少.
结论:
- 强制性VTE风险评估在改善预防和减少住院VTE方面更有效.
- 尽管预防措施有所改善,但退院后静脉瘤发病率上升,这表明需要扩大预防指南.
- 进一步研究延长退院后的VTE预防是有必要的,以完全减轻患者的风险.
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