比较在急诊科中使用医嘱工具对治疗方案依从性的影响。
Comparison of Ordering Tools on Adherence to Treatment Protocols in the Emergency Department.
机构信息
Geisinger, Danville, PA.
Oregon Health & Science University, Portland, OR.
出版信息
AMIA Annu Symp Proc. 2023 Apr 29;2022:739-745. eCollection 2022.
OBJECTIVE
To assess adherence to clinical protocols in the emergency department after the implementation of embedded order panels in the electronic health record.
MATERIALS AND METHODS
Due to infrequent use, a subset of order sets were redesigned as embedded order panels in a menu-style quick list. Usage was measured before and after implementation at seven departments.
RESULTS
There were 2,247 applicable encounters during the pre-intervention period and 1,723 post-intervention. The use of order sets increased significantly after implementation (14% vs. 33% or encounters, p < 0.001). Traditional order sets required at least seven keystrokes or mouse clicks, while embedded order panels required only two.
DISCUSSION AND CONCLUSION
Use of order sets increased after implementation of embedded order panels; however, they were still only used for about one-third of applicable encounters suggesting that more work is needed to increase treatment protocol adherence and electronic health record efficiency.
目的
评估电子病历中嵌入式医嘱面板实施后急诊临床医嘱遵循情况。
材料与方法
由于使用频率较低，部分医嘱集被重新设计为菜单式快速列表中的嵌入式医嘱面板。在七个科室实施前后分别进行了使用测量。
结果
干预前有 2247 例适用的就诊记录，干预后有 1723 例。实施后医嘱集的使用明显增加（14%比 33%，就诊记录，p<0.001）。传统医嘱集至少需要 7 次击键或鼠标点击，而嵌入式医嘱面板仅需两次。
讨论与结论
实施嵌入式医嘱面板后，医嘱集的使用增加了；然而，它们仍仅用于约三分之一的适用就诊记录，这表明需要进一步努力来提高治疗方案的遵循率和电子病历的效率。
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