Lee Guna, Lee Yura, Chong Yong Pil, Jang Seongsoo, Kim Mi Na, Kim Jeong Hoon, Kim Woo Sung, Lee Jae-Ho
Medical Information Office, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
J Med Internet Res. 2016 Oct 26;18(10):e282. doi: 10.2196/jmir.6398.
To evaluate patients with fever of unknown origin or those with suspected bacteremia, the precision of blood culture tests is critical. An inappropriate step in the test process or error in a parameter could lead to a false-positive result, which could then affect the direction of treatment in critical conditions. Mobile health apps can be used to resolve problems with blood culture tests, and such apps can hence ensure that point-of-care guidelines are followed and processes are monitored for blood culture tests.
In this pilot project, we aimed to investigate the feasibility of using a mobile blood culture app to manage blood culture test quality. We implemented the app at a university hospital in South Korea to assess the potential for its utilization in a clinical environment by reviewing the usage data among a small group of users and by assessing their feedback and the data related to blood culture sampling.
We used an iOS-based blood culture app that uses an embedded camera to scan the patient identification and sample number bar codes. A total of 4 medical interns working at 2 medical intensive care units (MICUs) participated in this project, which spanned 3 weeks. App usage and blood culture sampling parameters (including sampler, sampling site, sampling time, and sample volume) were analyzed. The compliance of sampling parameter entry was also measured. In addition, the participants' opinions regarding patient safety, timeliness, efficiency, and usability were recorded.
In total, 356/644 (55.3%) of all blood culture samples obtained at the MICUs were examined using the app, including 254/356 (71.3%) with blood collection volumes of 5-7 mL and 256/356 (71.9%) with blood collection from the peripheral veins. The sampling volume differed among the participants. Sampling parameters were completely entered in 354/356 cases (99.4%). All the participants agreed that the app ensured good patient safety, disagreed on its timeliness, and did not believe that it was efficient. Although the bar code scanning speed was acceptable, the Wi-Fi environment required improvement. Moreover, the participants requested feedback regarding their sampling quality.
Although this app could be used in the clinical setting, improvements in the app functions, environment network, and internal policy of blood culture testing are needed to ensure hospital-wide use.
为评估不明原因发热患者或疑似菌血症患者,血培养检测的准确性至关重要。检测过程中的不当步骤或参数错误可能导致假阳性结果,进而在危急情况下影响治疗方向。移动健康应用程序可用于解决血培养检测的问题,因此此类应用程序可确保遵循即时护理指南并监测血培养检测流程。
在这个试点项目中,我们旨在研究使用移动血培养应用程序管理血培养检测质量的可行性。我们在韩国的一家大学医院实施了该应用程序,通过审查一小群用户的使用数据,并评估他们的反馈以及与血培养采样相关的数据,来评估其在临床环境中的应用潜力。
我们使用了一款基于iOS的血培养应用程序,该应用程序使用嵌入式摄像头扫描患者识别码和样本编号条形码。共有4名在2个医疗重症监护病房(MICU)工作的医学实习生参与了这个为期3周的项目。分析了应用程序的使用情况和血培养采样参数(包括采样人员、采样部位、采样时间和样本量)。还测量了采样参数输入的合规性。此外,记录了参与者对患者安全、及时性、效率和可用性的意见。
在MICU采集的所有血培养样本中,共有356/644(55.3%)使用该应用程序进行了检测,其中254/356(71.3%)的采血量为5 - 7 mL,256/356(71.9%)的血样采集自外周静脉。参与者之间的采样量有所不同。354/356例(99.4%)的采样参数被完整输入。所有参与者都认为该应用程序确保了良好的患者安全,对其及时性存在分歧,并且不认为它是高效的。尽管条形码扫描速度可以接受,但Wi-Fi环境需要改进。此外,参与者要求提供有关其采样质量的反馈。
尽管该应用程序可在临床环境中使用,但需要改进应用程序功能、环境网络和血培养检测的内部政策,以确保在全院范围内使用。