通过临床医生促使干预措施,增加护理率的上下文化
Alan Schwartz1, Saul J Weiner2
1Departments of Medical Education and Pediatrics, University of Illinois at Chicago, 808 S. Wood St, 986 CME, Chicago, IL 60612, USA.
促使临床医生考虑患者的背景可以改善护理规划. 审计和反 (A&F),临床决策支持 (CDS) 和开放访问 (OA) 策略增强了上下文化,探测红旗显著增加了计划的整合.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 临床信息学 临床信息学
- 以患者为中心的护理
背景情况:
- 对患者护理进行上下文化对于改善健康结果至关重要.
- 临床提示策略,包括审计和反 (A&F),临床决策支持 (CDS) 和开放访问 (OA) 访问记录,旨在增加患者上下文的整合.
- 了解这些干预措施对临床医生的行为的影响对于有效实施至关重要.
研究的目的:
- 测量提示干预对临床医生探测上下文红旗的影响.
- 评估这些干预措施对将上下文因素纳入患者护理计划的影响.
主要方法:
- 三项涉及A&F,CDS和OA提示的受控研究的个人参与者数据元分析.
- 用4C系统编码患者访问的音频录音,以识别上下文红旗,临床医生探针和护理计划上下文化.
- 分析了来自4160次访问 (A&F),450次访问 (CDS) 和317次访问 (OA) 的数据.
主要成果:
- 提示性干预显著增加了探测上下文红旗的几率,平均为71% .
- 这些干预措施还增加了33%的护理计划上下文化的几率,部分由红旗探测调解.
- 与获得护理,财务状况,情绪状态以及技能,能力和知识相关的上下文因素最常被纳入护理计划.
结论:
- 多种策略有效地促使临床医生在护理规划中考虑患者的生活背景.
- 这些策略的有效性取决于具体的患者环境.
- 未来的努力应该探索结合促使干预和为临床医生提供特定领域的资源.
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