用医疗记录审查识别住院患者不良事件的触发器工具的预测值:系统性审查
Luis Meave Gutiérrez-Mendoza1, Elizabeth Manias2,3, Patricia Nicholson1
1School of Nursing and Midwifery, Centre for Quality and Patient Safety Research, Institute for Health Transformation, Deakin University, Geelong, VIC, Australia.
概括
卫生保健改进研究所的全球触发工具有效地识别住院患者的不良事件. 这次系统审查强调了其强大的预测价值和临床使用的可行性.
科学领域:
- 改善医疗保健质量 改善医疗保健质量
- 患者安全研究的研究.
- 医疗记录分析 医疗记录分析
背景情况:
- 在医院中识别不良事件使用各种方法,包括触发工具.
- 触发工具涉及对医疗记录 (纸质,电子或混合) 的回顾性审查.
- 了解这些工具的预测价值对于准确的流行率至关重要.
研究的目的:
- 系统地审查和描述用于识别住院患者不良事件的触发工具的预测价值.
- 综合有关不同触发工具方法的有效性的证据.
主要方法:
- 从2000年到2024年10月,对主要数据库 (MEDLINE,EMBASE,CINAHL,Cochrane图书馆) 进行系统搜索.
- 将同行评审的研究纳入英语或西班牙语报告,以确定不良事件的触发工具方法.
- 由两个独立的审稿人进行数据提取和合成,以算术平均值计算的聚合预测值.
主要成果:
- 综述包括来自37个国家的100项研究.
- 卫生保健改进研究所的全球触发工具显示了强大的预测值 (例如,86.6%的灵敏度,68.2%的特异性).
- 哈佛医学实践研究报告了较低的预测值 (例如,11.5%的特异性).
结论:
- 卫生保健改进研究所的全球触发工具展示了强大的预测值,用于识别住院患者的不良事件.
- 它的灵活性和可行性使其成为临床应用的合适选择.
- 进一步的研究可能会完善触发工具的方法,以提高准确性.
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