改善静脉血栓栓塞风险评估和血栓预防的临床决策支持工具,在电子药物管理系统中规定合规性:一项回顾性观察性研究
Samantha Loh1, Kimberly Wijaya2, Michelle Rogers2
1Pharmacy Department, Cabrini Health, 183 Wattletree Road Malvern, Malvern, VIC, 3144, Australia. sloh2@cabrini.com.au.
International journal of clinical pharmacy
|January 8, 2025
概括
实施电子警报系统改善了静脉血栓栓塞 (VTE) 风险评估和医院的预防处方. 这种临床决策支持工具通过确保及时采取VTE预防措施,提高了患者的安全性.
科学领域:
- 医疗保健信息学 医疗保健信息学
- 改善临床质量 改善临床质量
- 患者安全 患者安全
背景情况:
- 尽管采取了各种干预措施,但医院对静脉血栓栓塞 (VTE) 预防的遵守仍然不够理想.
- 电子药物管理系统 (eMMS) 为实施临床决策支持 (CDS) 工具提供了一个平台,以改善VTE预防.
研究的目的:
- 评估基于计算机化医生订单输入 (CPOE) 的集订单的集成电子警报系统是否可以改善静脉瘤风险评估和预防处方.
- 评估CDS工具在eMMS中对住院患者静脉瘤预防的影响.
主要方法:
- 一项追溯观察研究,比较电子警报系统和CPOE订单集的实施前后情况.
- 包括850名住院患者 (458名干预前,392名干预后) 在7天内连续查.
- 评估遵守当地VTE预防协议,重点关注风险评估文档和预防处方.
主要成果:
- 在24小时内,VTE风险评估文档增加了29.9% (p < 0.001).
- 符合指导方针的VTE预防改善了10.4% (p < 0.001).
- 具有记录风险评估的患者获得适当预防的可能性显著增加 (19.3%的差异,p < 0.001). 调整后的赔率比率从1.95到4.89不等 (p < 0.001).
结论:
- 在eMMS中与CPOE集成的CDS的本地实施显著改善了VTE风险评估文档.
- 电子警报系统提高了符合指导方针的VTE预防处方率.
- 这种技术方法有效地解决了医院环境中VTE预防实践的差距.
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