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物联网在医疗保健中的患者安全应用:一项实证研究。

Internet of things in healthcare for patient safety: an empirical study.

机构信息

Center for Healthcare Engineering, Department of Mechanical and Industrial Engineering, University of Toronto, Toronto, Canada.

Chief Information Officer and Chief Medical Information Officer, Mackenzie Health, Toronto, Ontario, Canada.

出版信息

BMC Health Serv Res. 2022 Mar 1;22(1):278. doi: 10.1186/s12913-022-07620-3.

Abstract

INTRODUCTION

This study evaluates the impact of an Internet of Things (IoT) intervention in a hospital unit and provides empirical evidence on the effects of smart technologies on patient safety (patient falls and hand hygiene compliance rate) and staff experiences.

METHOD

We have conducted a post-intervention analysis of hand hygiene (HH) compliance rate, and a pre-and post-intervention interrupted time-series (ITS) analysis of the patient falls rates. Lastly, we investigated staff experiences by conducting semi-structured open-ended interviews based on Roger's Diffusion of Innovation Theory.

RESULTS

The results showed that (i) there was no statistically significant change in the mean patient fall rates. ITS analysis revealed non-significant incremental changes in mean patient falls (- 0.14 falls/quarter/1000 patient-days). (ii) HH compliance rates were observed to increase in the first year then decrease in the second year for all staff types and room types. (iii) qualitative interviews with the nurses reported improvement in direct patient care time, and a reduced number of patient falls.

CONCLUSION

This study provides empirical evidence of some positive changes in the outcome variables of interest and the interviews with the staff of that unit reported similar results as well. Notably, our observations identified behavioral and environmental issues as being particularly important for ensuring success during an IoT innovation implementation within a hospital setting.

摘要

介绍

本研究评估了物联网 (IoT) 干预措施对医院病房的影响,并提供了有关智能技术对患者安全(患者跌倒和手部卫生合规率)和员工体验的影响的实证证据。

方法

我们对手部卫生 (HH) 合规率进行了干预后分析,并对患者跌倒率进行了干预前和干预后中断时间序列 (ITS) 分析。最后,我们根据罗杰斯的创新扩散理论进行了半结构化开放式访谈,以调查员工的体验。

结果

结果表明:(i) 患者跌倒率的平均值没有统计学意义的变化。ITS 分析显示,平均患者跌倒的增量变化无统计学意义(每季度每 1000 名患者 -0.14 次跌倒)。(ii) 所有员工类型和房间类型的 HH 合规率在第一年观察到增加,然后在第二年下降。(iii) 对护士进行的定性访谈报告称,直接患者护理时间有所改善,患者跌倒的数量减少。

结论

本研究为感兴趣的结果变量提供了一些积极变化的实证证据,并且该病房的员工访谈也报告了类似的结果。值得注意的是,我们的观察结果确定了行为和环境问题对于确保在医院环境中实施物联网创新时取得成功非常重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2493/8889732/02e27e0781f7/12913_2022_7620_Fig1_HTML.jpg

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