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当前可用电子健康记录系统中营养文档功能及营养治疗医嘱的随访调查

Follow-Up Survey on Functionality of Nutrition Documentation and Ordering Nutrition Therapy in Currently Available Electronic Health Record Systems.

作者信息

Vanek Vincent W, Ayers Phil, Charney Pamela, Kraft Michael, Mitchell Ronelle, Plogsted Steven, Soden Jason, Van Way Charles W, Wessel Jacqueline, Winter John, Kent Sue, Turner Peggy, Bouche Jean, Quirk Donna, Seidner Douglas L

机构信息

American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) Clinical Nutrition Informatics Committee (CNIS), St Elizabeth Youngstown Hospital, Youngstown, Ohio, USA

A.S.P.E.N. CNIS, Mississippi Baptist Medical Center, Jackson, Mississippi.

出版信息

Nutr Clin Pract. 2016 Jun;31(3):401-15. doi: 10.1177/0884533616629619. Epub 2016 Feb 26.

Abstract

BACKGROUND

This is a follow-up survey to reassess the safety and efficacy of nutrition content in the available electronic health record (EHR) systems.

MATERIALS AND METHODS

Members of the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.), American Society for Nutrition, and the Academy for Nutrition and Dietetics were asked to participate in an online survey. The survey included questions from a 2012 EHR survey on the safety and efficacy in 5 nutrition content areas as well as questions from previous 2003 and 2011 A.S.P.E.N. parenteral nutrition (PN) surveys.

RESULTS

Percent of respondents using an EHR and using the EHR for less than 1 year increased between 2012 and 2014 (86%-94%, P < .05; 11%-16%, P < .05, respectively). However, there was no improvement in the safety and efficacy of the 5 nutrition content areas, with a significant decrease in 2 of these areas, ordering oral nutrition supplements and ordering PN. The top-rated EHR vendors had a higher average favorable response rate in regards to safety and efficacy in the nutrition content areas but even the top-rated EHR vendor had only a 60% average in favorable responses. Reported use of electronic PN ordering and a direct interface between the EHR and the automated compounding device (ACD) significantly increased from 2003 to 2011 to 2014 (29% to 33% to 63% and 16% to 19% to 28%, respectively, P < .05).

CONCLUSIONS

This is a call to action to nutrition support clinicians, societies, and organizations to proactively be involved in initiatives to educate clinicians and collaborate with EHR vendors to enhance the EHR systems to improve the safety and efficacy of providing nutrition therapy in hospitalized patients.

摘要

背景

这是一项后续调查,旨在重新评估现有电子健康记录(EHR)系统中营养内容的安全性和有效性。

材料与方法

美国肠外与肠内营养学会(A.S.P.E.N.)、美国营养学会以及营养与饮食学会的成员受邀参与一项在线调查。该调查包括2012年EHR调查中关于5个营养内容领域安全性和有效性的问题,以及2003年和2011年A.S.P.E.N.肠外营养(PN)调查中的问题。

结果

2012年至2014年间,使用EHR以及使用EHR不到1年的受访者比例有所增加(分别为86% - 94%,P <.05;11% - 16%,P <.05)。然而,5个营养内容领域的安全性和有效性并无改善,其中2个领域出现显著下降,即口服营养补充剂的开具和PN的开具。在营养内容领域的安全性和有效性方面,排名靠前的EHR供应商平均好评率更高,但即使是排名靠前的EHR供应商,平均好评率也仅为60%。从2003年到2011年再到2014年,电子PN开具的报告使用情况以及EHR与自动配液装置(ACD)之间的直接接口显著增加(分别从29%增至33%再增至63%,以及从16%增至19%再增至28%,P <.05)。

结论

这是呼吁营养支持临床医生、学会和组织积极参与相关倡议,以教育临床医生并与EHR供应商合作,改进EHR系统,提高住院患者营养治疗的安全性和有效性。

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