医院医学的决策疲劳:一个追溯的探索性评估
Rachel M Kruer1, LaKeisha Boyd2, Lauren Czosnowski3
1Inpatient Clinical Pharmacy Services, Indiana University Health-Adult Academic Health Center, Indianapolis, Indiana, USA.
决策疲劳 (DF) 没有随着连续工作日的增加而增加. 然而,较高的患者工作负载与更多的DF事件有关,这表明工作负载会影响临床决策质量.
科学领域:
- 医疗决策的制定 医疗决策的制定
- 改善医疗保健质量 改善医疗保健质量
- 临床操作 临床操作
背景情况:
- 决策疲劳 (DF) 被定义为由于累积决策而导致决策能力受损.
- 在临床环境中了解DF对于保持患者安全和护理质量至关重要.
研究的目的:
- 在临床工作区块中调查决策疲劳的发生情况.
- 研究决策疲劳与医院工作特征之间的关系.
主要方法:
- 在两个月内对医院医生与患者的接触进行了回顾性分析.
- 通过多方利益相关者的共识确定了潜在的DF事件 (例如,药物冲突,低血糖症,过度使用资源).
- 数天对服务,患者普查和医生熟悉事件发生的评估影响.
主要成果:
- 决策疲劳事件与医院工作人员连续服务的日数无关.
- 增加患者普查与更高的决策疲劳事件的可能性显著相关.
- 每天超过13名患者的工作负载将决策疲劳事件的几率提高了1.58倍.
结论:
- 决策疲劳与延长的临床服务时间无关.
- 高患者工作负载对临床决策的质量构成重大风险.
- 医疗保健系统应考虑工作负载管理,以减轻决策疲劳并确保患者的安全.
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