School of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
Comprehensive Injury Center, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
BMJ Open. 2022 Jan 6;12(1):e052344. doi: 10.1136/bmjopen-2021-052344.
Our understanding of community violence is limited by incomplete information, which can potentially be resolved by collecting violence-related injury information through healthcare systems in tandem with prior data streams. This study assessed the feasibility of implementing Cardiff Model data collection procedures in the emergency department (ED) setting to improve multisystem data sharing capabilities and create more representative datasets.
Information collection fields were incorporated into the ED electronic health record (EHR), which gathered additional information from patients reporting assaultive injuries. ED nurses were surveyed to evaluate implementation and feasibility of information collection. Logistic regression was performed to determine associations between missing location information and patient demographic data.
60-bed academic level I trauma adult ED in a large Midwestern city.
2648 patients screened positive for assault injuries between 2017 and 2020. 198 patients were omitted due to age outside the range served by this ED. Unselected inclusion of 150 ED nurses was surveyed.
Main outcomes include nursing staff survey responses and ORs for providing complete injury information across various patient demographics.
Most ED nurses believed that information collection aligned with the hospital's mission (92%), wanted information collection to continue (88%), did not believe that information collection impacted their workflow (88%), and reported taking under 1 min to screen and document violence information (77%). 825 patients (31.2%) provided sufficient information for geospatial mapping. Likelihood of providing complete location information was significantly associated with patient gender, race, arrival means, accompaniment, trauma type and year.
It is feasible to implement information collection procedures about location-based, assault-related injuries through the EHR in the adult ED setting. Nurses reported being receptive to collecting information. Analyses suggest patient-level and time variables impact information collection completeness. The geospatial information collected can greatly improve preexisting law enforcement and emergency medical systems datasets.
由于信息不完整，我们对社区暴力的了解受到限制，而通过医疗保健系统与先前的数据流并行收集与暴力相关的伤害信息，可能会解决这个问题。本研究评估了在急诊室 (ED) 环境中实施加的夫模型数据收集程序的可行性，以提高多系统数据共享能力并创建更具代表性的数据集。
将信息收集字段纳入 ED 电子健康记录 (EHR) 中，该记录从报告攻击伤害的患者那里收集额外信息。对 ED 护士进行调查，以评估信息收集的实施和可行性。进行逻辑回归以确定缺失位置信息与患者人口统计学数据之间的关联。
中西部大城市的一家 60 张床位的学术一级创伤成人 ED。
2017 年至 2020 年间，有 2648 名筛查出有攻击伤的患者呈阳性。由于年龄超出该 ED 服务范围，有 198 名患者被排除在外。对未选择的 150 名 ED 护士进行了调查。
主要结果包括护理人员的调查答复以及在各种患者人口统计学数据中提供完整伤害信息的 OR。
大多数 ED 护士认为信息收集符合医院的使命（92%），希望继续收集信息（88%），不认为信息收集会影响他们的工作流程（88%），并且报告筛选和记录暴力信息的时间不到 1 分钟（77%）。825 名（31.2%）患者提供了足够的地理空间映射信息。提供完整位置信息的可能性与患者的性别、种族、到达方式、陪伴、创伤类型和年份显著相关。
在成人 ED 环境中，通过 EHR 实施基于位置的、与攻击相关的伤害信息收集程序是可行的。护士表示愿意收集信息。分析表明，患者层面和时间变量会影响信息收集的完整性。收集的地理空间信息可以极大地改善现有的执法和紧急医疗系统数据集。
