在电子健康记录中优化伤口培养排序:一个案例报告
John J Hanna1,2,3,4, Jenny L Weon5, Kathryn Kelton6
1Division of Infectious Diseases, East Carolina University Brody School of Medicine, Greenville, United States.
Applied clinical informatics
|February 27, 2025
概括
改善创伤培养的电子健康记录 (EHR) 订购,大大减少了不适当的组织样本提交. 有针对性的EHR优化可以提高适当的微生物学测试对伤口感染的订购.
科学领域:
- 医学实验室科学 医学实验室科学
- 医疗信息学 医疗信息学
- 临床微生物学 临床微生物学
背景情况:
- 低于最佳的电子健康记录 (EHR) 菜单设计导致频繁错误的组织样本伤口培养的订单.
- 伤口培养通常要求慢性伤口,急性感染的怀疑较低,这表明测试使用不适当.
研究的目的:
- 报告特定的EHR测试菜单设计修改,旨在提高微生物学测试订单的适当性.
- 评估EHR接口变化对伤口培养和组织培养顺序准确性的影响.
主要方法:
- 将"伤口培养"更名为"伤口培养",并引入"组织培养"快速订单.
- 实施了用于"伤口培养"的诊断问卷,以评估感染的临床指标 (,红血,手术伤口状态).
主要成果:
- 错误的组织样本提交与伤口培养订单从6.6%降至0%.
- 诊断问卷使用率为27.5%;根据问卷答复,6.1%的订单被认为可能不合适.
- 组织培养订单增加 (228至349),而伤口培养订单减少 (575至460),表明测试选择得到改善.
结论:
- 有针对性的EHR优化可以显著提高微生物学测试订购伤口感染的准确性.
- 界面设计的变化和临床决策支持工具提高了临床微生物学中适当的测试利用率.
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