Rosenbloom S Trent, Talbert Doug, Aronsky Dominik
Tennessee Technological Institute, Cookeville, TN, USA.
Int J Med Inform. 2004 Jun 15;73(5):433-41. doi: 10.1016/j.ijmedinf.2004.04.001.
Computerized provider order entry systems can improve patient care by integrating clinical decision support. Decision support is most effective when its content and delivery are acceptable. The authors report the results of a multifaceted survey of the attitudes of housestaff and medical student users of a provider order entry system with integrated decision support at an academic medical center. The survey contained 16 items covering four themes: efficiency, quality of care, results reporting and embedded guidelines. Responses were captured using a five point Likert scale, and were compared using ANOVA and Bartlett's testing. Out of 491 housestaff and 128 medical students, response rates were 47 and 29%, respectively. Among respondents, 72% agreed or strongly agreed that the provider order entry system improves the quality of care that they provide, 54% that the decision support usually help them to provide quality patient care, and 62% that it improves the efficiency of order entry. Respondents were least likely to agree that the display of prior laboratory results influenced their decision to order a subsequent test. There were no significant differences between subspecialties and by advancing years of training among housestaff. Respondents agreed that the integrated clinical decision support enhanced their medical training.
计算机化医嘱录入系统可通过整合临床决策支持来改善患者护理。当决策支持的内容和传递方式可接受时，其效果最为显著。作者报告了一项针对一所学术医疗中心使用带有整合决策支持功能的医嘱录入系统的住院医师和医学生用户态度的多方面调查结果。该调查包含16个项目，涵盖四个主题：效率、护理质量、结果报告和嵌入式指南。使用五点李克特量表获取回复，并通过方差分析和巴特利特检验进行比较。在491名住院医师和128名医学生中，回复率分别为47%和29%。在受访者中，72%同意或强烈同意医嘱录入系统提高了他们提供的护理质量，54%认为决策支持通常有助于他们提供高质量的患者护理，62%认为它提高了医嘱录入的效率。受访者最不可能同意既往实验室结果的显示会影响他们开出后续检查的决定。住院医师各亚专业之间以及随着培训年限的增加没有显著差异。受访者一致认为整合的临床决策支持增强了他们的医学培训。
