使用电子健康记录系统的推动来改善事先的护理规划:系统性审查
Tong Zhu1, Rongqing Wu1, Jiangxue Wu1
1Nursing Department, The Affiliated Hospital of Zunyi Medical University, No.149, Dalian Road, Huichuan District, Zunyi, 563099, Guizhou Province, China.
BMC palliative care
|July 2, 2025
概括
电子健康记录 (EHR) 推动提前医疗计划 (ACP) 文档和严重疾病的沟通. 然而,它们对患者结果的影响需要进一步调查.
科学领域:
- 医疗信息学 医疗信息学
- 行为科学 行为科学
- 医学伦理 医学伦理
背景情况:
- 刺激越来越多地被研究为改变行为.
- 电子健康记录 (EHR) 系统为医疗保健专业人员提供了新的方法来实施推动.
- 预先护理规划 (ACP) 是一个关键领域, nudges 可以促进重要的讨论和文档.
研究的目的:
- 审查和综合有关与电子健康记录系统集成的推动干预的证据.
- 评估这些EHR-nudges对各种预先护理计划 (ACP) 结果的影响.
主要方法:
- 在主要数据库中进行了系统的文献搜索,对随机对照试验 (RCT) 进行了搜索,直到2024年12月.
- 包括包括在医疗保健机构中基于电子健康记录的研究,报告了客观的ACP措施.
- 提取了数据,并评估了偏差风险;进行了叙事合成.
主要成果:
- 分析了10份报告 (9项研究),涉及27,556名参与者.
- EHR-nudges主要使用了原始化,突出/影响和默认策略.
- 在ACP文件,严重疾病对话,预后沟通,提前指令完成和护理目标文件方面观察到一致的积极效应.
结论:
- 整合到EHR的nudges在改善严重疾病患者的ACP文档和沟通方面表现有前途.
- 这些干预措施对下游临床结果的影响仍然不清楚.
- 由于研究的局限性和异质性,需要进行进一步的研究来证实这些发现.
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