减少在住院患者环境中未经指示使用IV拉的情况
Ashwin Kumar1, John Lynch1, Jennifer Baldwin1
1Department of Medicine, University of Connecticut Health Center, Farmington, Connecticut, USA.
JACC. Case reports
|November 14, 2025
概括
实施重新设计的订单组显著减少了住院患者的非指示静脉注射拉的使用,从69%降至25%. 这种干预,将决策支持与教育相结合,提高了用于高血压管理的药物安全性.
科学领域:
- 临床药房 临床药房
- 医疗信息学 医疗信息学
- 患者安全 患者安全
背景情况:
- 升高的血压 (BP) 在住院患者中很普遍,静脉注射 (IV) 抗高血压药经常被用于非紧急情况.
- 不适当的IV抗高血压剂使用可能会导致低血压和急性损伤等不良事件,而不会改善患者的结果.
- 在UConn John Dempsey医院使用IV拉的很大一部分 (69%) 缺乏适当的指示.
研究的目的:
- 为了减少住院患者在静脉注射拉的未经说明的使用.
- 评估重新设计的电子订单集和有针对性的教育在改善处方实践中的有效性.
主要方法:
- 实施了重新设计的订单组,要求选择由指南支持的拉的适用性.
- 该订单组包含了决策支持功能,包括显示最近的BP读数和指南链接.
- 为医疗保健提供者进行了关于管理高血压的最佳实践和替代方案的教育课程.
主要成果:
- 在干预后,未指示的IV拉使用量从69%大幅下降到25%.
- 与单独教育相比,重新设计的订单集在减少不适当使用方面产生了更大的影响.
- 干预成功地提高了IV拉处方的适当性.
结论:
- 订单组修改嵌入决策支持是有效的减少非指示的IV拉的使用.
- 针对性教育和增强的订单集的结合提供了一个可扩展的模型,用于更安全的住院药物处方.
- 这种方法可以复制,以提高其他静脉注射疗法的药物安全性.
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