不仅仅是一个消息:死亡由1000个"聊天"死亡
Darcy Wooten1, Christian Hendrix1, Joshua Nordman1
1Division of Infectious Diseases, Department of Medicine, Washington University in St Louis School of Medicine, St. Louis, MO, USA.
概括
电子健康记录 (EHR) 中的安全电子信息有助于快速沟通,但扰乱了传染病 (ID) 顾问. 清晰的界限和有目的的沟通策略对于患者护理和临床医生的福祉至关重要.
科学领域:
- 医疗信息学 医疗信息学
- 临床传播 临床沟通
- 医疗实践管理 医疗实践管理
背景情况:
- 安全的电子通讯系统,如电子健康记录 (EHR) 中的Epic Chat,通过实现快速的异步交互,彻底改变了医院的通信.
- 然而,大量的信息给传染病 (ID) 顾问带来了重大挑战,导致注意力分散,并破坏了临床推理.
- 微不足道,重复或随意措辞的信息的普遍性增加了错误沟通和潜在的医疗法律问题的风险.
研究的目的:
- 分析普遍的电子消息对传染病 (ID) 顾问工作流程和患者护理的影响.
- 倡导改善沟通实践,并在临床环境中为电子邮件建立更清晰的界限.
- 确定优化电子通信的策略,以提高患者安全和临床医生的福祉.
主要方法:
- 使用EHR消息传递的ID顾问面临的沟通模式和挑战的定性分析.
- 审查受电子信息过载影响的临床情景.
- 基于专家共识和最佳实践的实际策略的制定.
主要成果:
- 不断的电子邮件碎片临床医生的注意力,扰乱临床推理,并对患者安全构成风险.
- 不有效的消息传递有助于错误沟通和潜在的医疗法律风险.
- 当前的做法需要文化转变,朝着更有目的和有意的沟通.
结论:
- 确定电子邮件与直接通信之间的界限至关重要.
- 实施诸如响应分批,保护焦点时间和促进消息礼仪等策略可以减轻负面影响.
- 沟通方法的故意性对于优化患者护理和保护临床医生的福祉至关重要.
相关概念视频
02:27Nonsense-mediated mRNA Decay
The Upf proteins that carry out nonsense-mediated decay (NMD) are found in all eukaryotic organisms, including humans. Each protein has an individual role, but they need to work in collaboration. Upf1 is an ATP-dependent RNA helicase that unwinds the RNA helix. Because Upf1 can unwind any RNA, Upf2 and Upf3 are required to help Upf1 discriminate between nonsense and normal mRNAs.
Usually, Upf3 binds to an Exon Junction Complex (EJC) at mRNA splice sites. If a ribosome fully translates the mRNA,...
Usually, Upf3 binds to an Exon Junction Complex (EJC) at mRNA splice sites. If a ribosome fully translates the mRNA,...
01:30Overview of Cell Death
Cell death is an essential process where the body gets rid of old or damaged cells. Cell proliferation and death need to be balanced, as an imbalance between the two may lead to cancer or autoimmune diseases.
Cell death was observed in the early 19th century, but there was no experimental evidence to prove it. In 1842, Carl Vogt first discovered cell death in a metamorphic toad; however, it was not termed ‘cell death.’ Scientists discovered different cell death pathways only in the 20th century...
Cell death was observed in the early 19th century, but there was no experimental evidence to prove it. In 1842, Carl Vogt first discovered cell death in a metamorphic toad; however, it was not termed ‘cell death.’ Scientists discovered different cell death pathways only in the 20th century...
01:17Phagocytosis of Apoptotic Cells
Cells undergoing apoptosis form apoptotic bodies that must be removed immediately to prevent inflammation, autoimmune diseases, and necrosis. Phagocytosis is carried out by professional phagocytes such as macrophages or immature dendritic cells. Non-professional phagocytes such as epithelial cells and fibroblasts also take part in this process; however, they are not as effective as professional phagocytes.
Normal cells contain receptors that prevent them from being recognized by phagocytes.
Normal cells contain receptors that prevent them from being recognized by phagocytes.
01:18Autophagic Cell Death
Christian de Duve discovered “autophagy,” a process in which cellular components are engulfed by membrane-bound organelles called autophagosomes. The autophagosomes then fuse with lysosomes to digest the enclosed contents. Autophagy is generally activated in cells to prevent cell death. However, cell death is triggered when the damage is beyond repair.
Autophagy and Apoptosis
Autophagy can activate apoptosis. In normal conditions, the autophagy activating protein Beclin-1 and pro-apoptotic...
Autophagy and Apoptosis
Autophagy can activate apoptosis. In normal conditions, the autophagy activating protein Beclin-1 and pro-apoptotic...
01:16Necrosis
Necrosis is considered as an “accidental” or unexpected form of cell death that ends in cell lysis. The first noticeable mention of “necrosis” was in 1859 when Rudolf Virchow used this term to describe advanced tissue breakdown in his compilation titled “Cell Pathology”.
Morphological Manifestations of Necrosis
Necrotic cells show different types of morphological appearance depending on the type of tissue and infection. In coagulative necrosis, cells become anucleated and die, but their...
Morphological Manifestations of Necrosis
Necrotic cells show different types of morphological appearance depending on the type of tissue and infection. In coagulative necrosis, cells become anucleated and die, but their...
02:27Nonsense-mediated mRNA Decay
The Upf proteins that carry out nonsense-mediated decay (NMD) are found in all eukaryotic organisms, including humans. Each protein has an individual role, but they need to work in collaboration. Upf1 is an ATP-dependent RNA helicase that unwinds the RNA helix. Because Upf1 can unwind any RNA, Upf2 and Upf3 are required to help Upf1 discriminate between nonsense and normal mRNAs.
Usually, Upf3 binds to an Exon Junction Complex (EJC) at mRNA splice sites. If a ribosome fully translates the mRNA,...
Usually, Upf3 binds to an Exon Junction Complex (EJC) at mRNA splice sites. If a ribosome fully translates the mRNA,...