关于CDS故障的特别问题:由于过于复杂的CDS指令导致儿科术后抗生素的意外延迟
Swaminathan Kandaswamy1, Sarah A Thompson2, Edwin Ray3
1Emory University, Atlanta, United States.
Applied clinical informatics
|August 28, 2025
概括
一个临床决策支持 (CDS) 警报,旨在加快儿科重症监护室 (PICU) 的手术后抗生素订单. 这凸显了需要仔细监测和最终用户参与电子健康记录警报的发展.
科学领域:
- 医疗信息学
- 患者安全
- 临床决策支持系统
背景情况:
- 在手术后及时服用抗生素对于预防手术部位感染至关重要.
- 在将患者转移到儿科重症监护室 (PICU) 后,发现了抗生素订单的延迟.
- 一个临床决策支持 (CDS) 系统被开发来改善及时的订单激活.
研究的目的:
- 设计一个 CDS 系统,以便及时发布手术后的订单.
- 评估CDS干预的有效性.
- 分享实施经验教训.
主要方法:
- 采用了利益相关者采访和分阶段实施的方法.
- 一个打断电子健康记录的警报被设计为促使护士释放持有订单.
- 对药物释放时间进行了干预前和后的比较.
主要成果:
- CDS警报与发布订单的时间延长有关.
- 可用性测试显示护士感到困惑,导致戒备停止.
- 事后分析表明延迟可能与季节性趋势一致.
结论:
- CDS的实施对订单发布时间产生了意想不到的不利影响.
- 最终用户参与和可用性测试对于有效的CDS设计至关重要.
- 对于医疗保健中的技术干预来说, 必须进行彻底的监测和评估.
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