一个新的电子健康记录集成的临床途径,用于结石病:开发和管理结果
Soum D Lokeshwar1, Ankur U Choksi1, Shayan Smani1
1Department of Urology, Yale University School of Medicine, New Haven, Connecticut.
Urology practice
|June 3, 2025
概括
对结石的新电子健康记录途径改善了疼痛管理和药物使用. 这种标准化的方法减少了阿片类药物的使用,并改善了急诊室的患者护理.
科学领域:
- 紧急医疗 紧急医疗
- 腎臟病學 (nephrology) 是一種醫學專業.
- 医疗信息学 医疗信息学
背景情况:
- 由于结石病引起的急性结是急诊室 (ED) 频繁出现的情况.
- 临床管理的变化导致了诸如阿片类药物使用增加,非最佳出院计划和经常性急救诊所访问等问题.
- 护理的标准化对于改善患者的治疗结果和资源利用至关重要.
研究的目的:
- 评估电子健康记录集成的临床途径对ED中结石病的管理的影响.
- 评估疼痛控制,出院实践和整体患者护理方面的改进.
- 促进基于证据的结石管理策略.
主要方法:
- 在9个EDS中对患有结肠或尿道结石的患者进行了回顾性队列研究.
- 对2023年1月1日至12月31日的数据进行分析.
- 关键结果包括阿片类药物替代利用 (凯托洛拉克,IV利多卡因),坦苏洛辛处方率,以及使用曼·惠特尼U测试,皮尔森千平方测试和后勤回归分析的泌尿器科随访时间.
主要成果:
- 在5733名患者中,10%的人使用了结石病途径.
- 途径利用显著增加了推的凯托洛拉克剂量 (33.2%与26.8%相比),IV利多卡因使用 (5.6%与0.8%相比) 和28天的坦苏洛辛处方 (22.7%与6.8%相比) 的使用.
- 多变量分析证实了该途径的使用是增加凯托洛拉克,IV利多卡因和坦苏洛辛使用的预测因素.
结论:
- 整合到EHR的结石病路径有效地促进了基于证据的疼痛管理.
- 该途径鼓励使用非阿片类疼痛控制和适当的医疗驱逐疗法.
- 标准化的护理途径改善了结石病管理中的关键过程措施.
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