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住院患者的身体限制使用:对例行收集的健康记录数据的研究

James Luccarelli^1,2, Tsu K Gan³, Sara B Golas³

¹Massachusetts General Hospital, 32 Fruit Street, Yawkey 6A, Boston, MA, 02114, USA. jluccarelli@mgb.org.

Journal of general internal medicine

|October 10, 2024

概括

在医院使用身体克制影响了6.3%的患者,特别是在重症监护室 (ICU). 诸如男性性别和非英语语言等因素增加了克制率,但ICD-10编码高度不敏感.

科学领域:

医疗保健研究的研究.
患者的安全性患者安全性
临床信息学是一种临床信息学.

背景情况:

住院患者使用自控装置对患者和工作人员构成风险.
尽量减少安全座椅的使用是医院的一个关键目标.
准确评估限制模式对于减少策略至关重要.

研究的目的:

为了确定医疗保健网络中使用身体限制的比例.
根据护理背景,诊断和人口统计数据分析克制率.
评估ICD-10代码Z78.1的准确性,用于识别身体限制.

主要方法:

2017-2022年使用电子健康记录 (EHR) 对成人住院病例的回顾性分析.
收集的数据包括人口统计,诊断,护理区域,停留时间,死亡率和限制文档.
对 ICD-10 代码 Z78.1 与 EHR 命令和控制状态的流程表进行比较.

主要成果:

742,607例住院治疗中的6.3%涉及身体限制.
重症监护室 (ICU) 患者的克制率为39%,而其他地区的克制率为1.3%.
增加克制的几率与男性性别,年龄较大,未知种族和非英语语言有关;ICD-10代码Z78.1具有1.5%的灵敏度和99.99%的特异性.

结论:

临床,人口和运营因素影响医院的身体限制使用.
重症监护室 (ICU) 护理显著增加了克制的可能性.
由于ICD-10代码Z78.1的低敏感性,限制了依赖行政索赔数据的研究.

关键词:

群组研究是指群组研究.人口统计学人口统计学物理物理物理物理限制束器的使用方法

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