最佳实践警报（BPA）对微创子宫切除术后出院后阿片类药物处方的影响：一项质量改进研究。
Effect of Best Practice Alert (BPA) on Post-Discharge Opioid Prescribing After Minimally Invasive Hysterectomy: A Quality Improvement Study.
作者信息
Jankulov Alexandra, As-Sanie Sawsan, Zimmerman Christopher, Virzi Jessica, Srinivasan Sudharsan, Choe Hae Mi, Brummett Chad M
机构信息
Oakland University William Beaumont School of Medicine, Rochester Hills, MI, USA.
Department of Obstetrics & Gynecology, University of Michigan Health System, Ann Arbor, MI, USA.
出版信息
J Pain Res. 2024 Feb 14;17:667-675. doi: 10.2147/JPR.S432262. eCollection 2024.
PURPOSE
The aim of this study was to describe the effectiveness of an electronic health record best practice alert (BPA) in decreasing gynecologic post-discharge opioid prescribing following benign minimally invasive hysterectomy.
PATIENTS AND METHODS
The BPA triggered for opioid orders >15 tablets. Prescribers' options included (1) decrease to 15 ≤ tablets; (2) remove the order/utilize a defaulted order set; or (3) override the alert.
RESULTS
332 patients were included. The BPA triggered 29 times. The following actions were taken among 16 patients for whom the BPA triggered: "override the alert" (n=13); "cancel the alert" (n=2); and 'remove the opioid order set' (n=1). 12/16 patients had discharge prescriptions: one patient received 20 tablets; two received 10 tablets; and nine received 15 tablets. Top reasons for over prescribing included concerns for pain control and lack of alternatives.
CONCLUSION
Implementing a post-discharge opioid prescribing BPA aligned opioid prescribing following benign minimally invasive hysterectomy with guideline recommendations.
目的
本研究旨在描述电子健康记录最佳实践警报（BPA）在减少良性微创子宫切除术后出院时阿片类药物处方方面的有效性。
患者与方法
当阿片类药物处方超过15片时触发BPA。开处方者的选择包括：（1）减至15片≤；（2）取消订单/使用默认订单集；或（3）忽略警报。
结果
纳入332例患者。BPA触发了29次。在BPA触发的16例患者中采取了以下行动：“忽略警报”（n = 13）；“取消警报”（n = 2）；以及“移除阿片类药物订单集”（n = 1）。16例患者中有12例有出院处方：1例患者收到20片；2例收到10片；9例收到15片。过度开药的主要原因包括对疼痛控制的担忧和缺乏替代药物。
结论
实施出院后阿片类药物处方BPA使良性微创子宫切除术后的阿片类药物处方与指南建议保持一致。
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