优化肝素质量保证使用电子数据抽象
Elizabeth Lemanske1,2, Justin Zimmerman1,2, Paul Dobry1,2
1Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, Detroit, MI, USA.
概括
用于肝素质量保证的手动和电子数据收集显示了对治疗aPTT的良好协议,但对临床结果的协议很差. 混合方法可以提高肝素管理的效率.
科学领域:
- 药理学 药理学是指药理学的学科.
- 医疗信息学 医疗信息学
- 提高质量 提高质量
背景情况:
- 肝素是一种高风险药物,由于患者的变化,需要谨慎管理.
- 系统的数据分析对于优化肝素治疗和提高患者安全至关重要.
- 需要有效的数据收集流程来简化医院的抗凝固药品质量保证计划.
研究的目的:
- 评估手动和电子数据抽象方法之间对肝素质量保证的一致性.
- 确定与肝素治疗相关的关键绩效指标数据收集中的差异.
主要方法:
- 一个单中心的观察队列研究,包括288名接受未分离肝素的患者.
- 从药剂师表单和电子病历中手动提取的数据与来自机构数据仓库的数据进行比较.
- 使用kappa统计数据来评估治疗激活部分血栓形成时间 (aPTT) 的达成和临床结果的一致性.
主要成果:
- 观察到在24小时内达到治疗性aPTT的高度一致性 (kappa = 0.86).
- 在24小时内发现了治疗性或超治疗性aPTT的实质性一致性 (kappa = 0.69).
- 在识别随后的肝素胆固醇 (kappa = 0.13) 和新的静脉血栓塞栓症 (VTE) 病例 (kappa = -0.01) 方面,发现一致性较差.
结论:
- 肝素质量保证数据收集的可靠性在手动和电子方法之间有很大的差异.
- 为了提高效率,采用了结合手动和电子数据抽象的混合方法.
- 需要进一步的研究来概括这些发现,并改进对临床结果的电子数据捕获.
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