Burgess Mary J, Enzler Mark J, Kashiwagi Deanne T, Selby Andi J, Sohail M Rizwan, Daniels Paul R, Lahr Brian D, Lloyd Farrell, Baddour Larry D
J Healthc Qual. 2016 Nov/Dec;38(6):359-369. doi: 10.1097/JHQ.0000000000000070.
We assessed if use of an online clinical decision support tool improved standardization and quality of care in hospitalized patients with lower extremity cellulitis (LEC). This was a 14-month preintervention and postintervention study of 85 LEC admissions. There was significantly higher usage of the online LEC care process model (CPM) in the postintervention phase (p < .001). There was a trend toward higher rates of appropriate antibiotic regimen in the postintervention group both initially and at discharge (p = .063 for both). A sensitivity analysis of CPM users versus nonusers demonstrated a significantly higher rate of appropriate initial antibiotics prescribed when the CPM was used (p < .001). Use of this online CPM was associated with improved standardization, as demonstrated by increased ordering of an appropriate initial antibiotic regimen for hospitalized patients with LEC.
我们评估了使用在线临床决策支持工具是否能提高下肢蜂窝织炎（LEC）住院患者的护理标准化程度和质量。这是一项针对85例LEC入院患者的为期14个月的干预前和干预后研究。在干预后阶段，在线LEC护理流程模型（CPM）的使用率显著更高（p < 0.001）。干预后组在初始阶段和出院时使用适当抗生素治疗方案的比例均有上升趋势（两者p = 0.063）。对CPM使用者和非使用者的敏感性分析表明，使用CPM时开具适当初始抗生素的比例显著更高（p < 0.001）。如为LEC住院患者增加开具适当初始抗生素治疗方案所示，使用这种在线CPM与提高标准化程度相关。
