Tzeng Huey-Ming, Hu Hsou Mei, Yin Chang-Yi
Department of Nursing, School of Health Professions and Studies, University of Michigan-Flint, USA.
Comput Inform Nurs. 2011 Dec;29(12):721-9. doi: 10.1097/NCN.0b013e31822b8672.
Medicare no longer reimburses acute care hospitals for the costs of additional care required due to hospital-acquired injuries. Consequently, this study explored the effective computerized systems to inform practice for better interventions to reduce fall risk. It provided a correlation between type of computerized system and hospital-acquired injurious fall rates at acute care hospitals in California, Florida, and New York. It used multiple publicly available data sets, with the hospital as the unit of analysis. Descriptive and Pearson correlation analyses were used. The analysis included 462 hospitals. Significant correlations could be categorized into two groups: (1) meaningful computerized systems that were associated with lower injurious fall rates: the decision support systems for drug allergy alerts, drug-drug interaction alerts, and drug-laboratory interaction alerts; and (2) computerized systems that were associated with higher injurious fall rates: the decision support system for drug-drug interaction alerts and the computerized provider order entry system for radiology tests. Future research may include additional states, multiple years of data, and patient-level data to validate this study's findings. This effort may further inform policy makers and the public about effective clinical computerized systems provided to clinicians to improve their practice decisions and care outcomes.
医疗保险不再为因医院获得性损伤而产生的额外护理费用向急症医院报销。因此,本研究探索了有效的计算机化系统,以指导实践,采取更好的干预措施来降低跌倒风险。该研究揭示了加利福尼亚州、佛罗里达州和纽约州的急症医院中,计算机化系统类型与医院获得性伤害性跌倒发生率之间的关联。研究使用了多个公开数据集,以医院作为分析单位。采用了描述性分析和皮尔逊相关性分析。分析涵盖了462家医院。显著相关性可分为两类:(1)与较低伤害性跌倒发生率相关的有意义的计算机化系统:药物过敏警报、药物相互作用警报和药物与实验室相互作用警报的决策支持系统;(2)与较高伤害性跌倒发生率相关的计算机化系统:药物相互作用警报的决策支持系统和放射学检查的计算机化医嘱录入系统。未来的研究可能包括更多州、多年的数据以及患者层面的数据,以验证本研究的结果。这项工作可能会进一步让政策制定者和公众了解向临床医生提供的有效的临床计算机化系统,以改善他们的实践决策和护理结果。