没有C型肝炎病毒的内镜手术项目:医院内消除方法
Benjamin Lih-Ren Hsieh1, Yen-Ting Kuo2, Yu-Ju Wei1,3,4
1Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
The Kaohsiung journal of medical sciences
|January 16, 2025
概括
型肝炎无病毒内镜程序项目 (CEPP) 在台湾使用基于EMR的系统显著提高了抗HCV查率. 这一举措成功识别和治疗了患者,导致病毒根除,并推进了医院的微型消除工作.
科学领域:
- 肝病学和病毒性胃肠道学
- 公共卫生和流行病学
- 医疗保健信息学 医疗保健信息学
背景情况:
- 消除C型肝炎病毒 (HCV) 仍然是一个挑战,特别是对于接受侵入性手术的患者来说.
- 基于医院的微清除策略对于控制HCV传播至关重要.
- 有效的查和与护理的联系是HCV消除计划的重要组成部分.
研究的目的:
- 评估无HCV内镜手术项目 (CEPP) 在提高HCV查率方面的有效性.
- 评估基于电子病历 (EMR) 的提醒系统对接受内镜手术的患者的HCV检测的影响.
- 确定CEPP在促进HCV治疗级联和实现病毒根除方面的成功.
主要方法:
- 在胃肠道,外科,泌尿和妇科部门实施基于EMR的提醒系统.
- 积极订购抗HCV测试的病人没有在过去五年内测试.
- 在实施提醒系统之前 (A阶段) 和在实施期间 (B阶段) 的HCV查率的比较.
- 将抗HCV阳性患者招募到包括HCVRNA测试和直接作用抗病毒 (DAA) 治疗在内的护理级联中.
主要成果:
- 查率从A期的18.7%显著增加到B期的64.2% (p < 0.001).
- 医学部 (DOM) 显示,查率从21.1%大幅增加到89.3% (p < 0.001).
- 15名患者在B期检测出HCVRNA阳性,其中6人接受DAA并实现病毒根除.
结论:
- 使用基于EMR的提醒系统的CEPP显著提高了接受侵入性手术的患者的抗HCV查率.
- 该干预措施有效地促进了与护理和成功的HCV治疗的联系,证明了其对医院微小清除的价值.
- 有针对性的干预措施,特别是在DOM内部,有效地提高了查和实现HCV根除目标.
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