评估药物CDS可用性:来自10家门诊诊所的试点结果
Zoe Co1,2, David W Bates1,3,4, Jessica M Cole5
1Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, Michigan, United States.
Applied clinical informatics
|August 20, 2025
概括
在美国门诊诊所试行了一种针对药物警报的新人类因素评估. 许多诊所在整合人为因素方面表现出差异,其中40%允许绕过严重的药物相互作用警报.
科学领域:
- 医疗信息学 医疗信息学
- 人类因素工程 人类因素工程
- 患者安全 患者安全
背景情况:
- 与药物相关的临床决策支持 (CDS) 警报对于患者安全至关重要.
- 将人为因素原则纳入CDS设计是有效的警报管理的关键.
- 现有的工具,如与药物相关的决策支持警报 (I-MeDeSA) 中的人类因素原则评估工具,为评估提供了基础.
研究的目的:
- 开发和试点对与药物相关的CDS警报进行人为因素评估.
- 评估在门诊电子健康记录 (EHR) 系统中的药物相互作用 (DDI) 警报中整合人为因素原则.
- 确定在CDS警报设计和实施方面需要改进的领域.
主要方法:
- 基于经过验证的I-MeDeSA工具开发了一个人为因素评估,对问题和答案格式进行了修改.
- 该评估在美国10个门诊诊所进行试点测试,每个诊所使用不同的商业电子病历系统.
- 诊所触发了高度严重的DDI警报,随后完成了人为因素评估.
主要成果:
- 最终评估包括五个部分和十二个问题,涵盖警报时间,视觉方面,严重程度,内容和行动.
- 各诊所的平均整体得分为62%,这表明人为因素整合的差异很大.
- 虽然时间和视觉方面得分很高,但40%的诊所缺乏保护措施,以防止绕过"行动"部分的高严重性警报.
结论:
- 门诊诊所如何将人为因素原则纳入DDI警报中存在显著的变化.
- 一些EHR系统缺乏必要的药物保护措施,对患者的安全构成风险.
- 开发的人类因素评估可以被门诊机构用于有针对性的安全改进举措.
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