临床决策支持增加急诊室纳洛联合处方:实施报告
Stuart W Sommers1, Heather J Tolle1, Katy E Trinkley2,3
1Department of Emergency Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, 12401 East 17th Avenue, 7th Floor, Aurora, CO, 80045, United States, 1 2039821107.
JMIR medical informatics
|November 6, 2024
概括
临床决策支持 (CDS) 显著增加了急诊室临床医生的纳洛联合处方,改善了阿片类药物过量预防. 这种自动化的电子健康记录干预措施证明了持续的有效性和随着时间的推移而被采用.
科学领域:
- 公共卫生 公共卫生
- 临床信息学 临床信息学
- 紧急医疗 紧急医疗
背景情况:
- 与阿片类止痛药同时处方纳洛是一种CDC的最佳做法,以防止致命的阿片类药物过量服用.
- 紧急医疗临床医生对纳洛的共同处方仍然很少见,发生在不到5%的指示病例中.
- 之前的研究缺乏关于临床决策支持 (CDS) 设计和纳洛处方的务实结果的详细报告.
研究的目的:
- 严格评估和量化CDS对改善急诊室内纳洛联合处方的影响.
- 评估在CDS实施后从ED出院的患者填写纳洛处方的增加.
- 为了测试CDS会增加纳洛联合处方率的假设.
主要方法:
- 使用以用户为中心的原则设计和实施基于电子健康记录的自动,中断式CDS.
- 定义的高风险阿片类药物处方基于吗啡毫克相当量或患者病史.
- 使用RE-AIM框架评估结果,包括通过贝叶斯结构时间序列模型和处方填充率评估的有效性.
主要成果:
- CDS在ED诊所中达到15.99%的阿片类药物处方,临床医生在34.36%的警报中采用它.
- 纳洛联合处方增加了每周18.1例 (2,327%),显示出显著的有效性.
- 患者填补了43.80%的纳洛联合处方;CDS的采用和效果随着时间的推移而保持和增加.
结论:
- 基于电子健康记录的CDS有效地增加了纳洛的共同处方,并改善了纳洛的分配.
- 最少的中断性CDS显著改善了过程结果,控制了长期的趋势.
- 这项研究提供了强有力的证据,证明了CDS在促进纳洛联合处方方面的可复制性和有效性.
关键词:
临床决策支持系统临床决策支持系统药物监测 药物监测是指对药物进行监测.过量服用药物过量服用药物过量服用药物过量服用药物过量服用药物过量服用药物危害最小化 危害最小化减少伤害 减少伤害纳洛 (Naloxone) 是一种药物.纳洛的共同处方 纳洛的共同处方这是一种阿片类止痛药.过量服用阿片类药物过量服用开处方的阿片类药物.使用阿片类药物使用.订单集是一组订单集.更多相关视频
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