Siena College, Albany, NY.
School of Nursing, Columbia University, New York, NY; Department of Biomedical Informatics, Columbia University, New York, NY.
Am J Infect Control. 2020 Feb;48(2):124-131. doi: 10.1016/j.ajic.2019.07.027. Epub 2019 Oct 9.
There is a paucity of research on best practices for communication through the electronic health record (EHR) to support shared decision-making and to prevent adverse events. To explore this issue, this study focused on interprofessional communication around a specific clinical issue, the prevention of central line-associated bloodstream infections.
The Delphi technique was used to describe what information is needed to support decisions regarding central venous catheter (CVC) management, and best practices for communicating this information among the interprofessional team.
The expert panel, 4 physicians and 6 nurses, identified 12 information types necessary for decisions regarding CVC management and the removal of unnecessary lines. For each of the 12 information types, the panel reached agreement regarding the best channel to communicate this information, including asynchronous EHR formats and synchronous oral channels.
Findings address 2 important aspects of postinsertion CVC practices and a gap in the literature by moving beyond a description of current practices to a description of how the EHR ought to be used to support collaboration and interprofessional communication. Future research should examine how the communication practices identified in this study contribute to a reduction in central line-associated bloodstream infections.
关于如何通过电子健康记录 (EHR) 进行沟通以支持共享决策和预防不良事件，相关最佳实践的研究很少。为了探讨这个问题，本研究专注于围绕一个特定临床问题（预防中心静脉导管相关血流感染）的跨专业交流。
德尔菲技术用于描述支持有关中心静脉导管 (CVC) 管理决策所需的信息，以及在跨专业团队之间交流这些信息的最佳实践。
专家小组由 4 名医生和 6 名护士组成，确定了 12 种与 CVC 管理和去除不必要导管相关的决策所需的信息类型。对于 12 种信息类型中的每一种，专家组都就传达这些信息的最佳渠道达成了一致意见，包括异步 EHR 格式和同步口头渠道。
研究结果通过超越对当前实践的描述，进一步阐述了 EHR 应如何用于支持协作和跨专业交流，从而解决了插入后 CVC 实践的 2 个重要方面和文献中的一个空白。未来的研究应探讨本研究中确定的沟通实践如何有助于减少中心静脉导管相关血流感染。
