开发一种电子临床监测措施,用于在疑似败血症患者中不必要的快速使用抗生素
Stephanie Parks Taylor1,2, Jessica A Palakshappa3, Shih-Hsiung Chou4
1Division of Hospital Medicine, University of Michigan, Ann Arbor, Michigan, USA.
概括
根据电子健康记录标准定义的败血症过度治疗,影响了22.5%的潜在败血症患者. 这种过度治疗与抗生素使用的增加,住院时间的延长和死亡率的提高有关.
科学领域:
- 临床医学 临床医学
- 医疗信息学 医疗信息学
- 提高质量 提高质量
背景情况:
- 败血症治疗侧重于减少延迟,但败血症过度治疗的研究不足.
- 电子健康记录 (EHR) 数据为败血症过度治疗监测提供了潜力.
- 这项研究引入了败血症过度治疗监测 (SEP-OS) 度量.
研究的目的:
- 确定SEP过度治疗监测 (SEP-OS) 的EHR数据衍生标准的初步有效性和有用性.
- 描述患病率,患者特征和与败血症过度治疗相关的结果.
主要方法:
- 在12家医院评估了患有潜在败血症的成年人,不包括休克患者.
- 定义SEP-OS是对不符合真正败血症标准的患者进行快速静脉注射抗生素.
- 评估过度治疗的频率,特征和结果.
主要成果:
- 在113,764名符合条件的患者中,败血症过度治疗的患病率为22.5%.
- 在SEP-OS指标证明了可靠性和有效性.
- 过度治疗与更多的抗生素日,更长的住院时间,更高的死亡率和增加的C. difficile感染有关.
结论:
- 开发了一种新的,有效的EHR指标 (SEP-OS) 用于败血症过度治疗监测.
- 在潜在的败血症患者中发现过度治疗的高率.
- SEP-OS指标是败血症质量改善举措的宝贵工具.
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