结合基于电子病历的实时自动警报系统可以改善快速反应系统:一项回顾性队列研究。

Seung-Hun You, Sun-Young Jung, Hyun Joo Lee, Sulhee Kim, Eunjin Yang
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引用次数: 3

摘要

背景:快速反应系统(RRSs)是患者安全系统的重要组成部分;然而,关于它们的有效性和最佳结构的证据有限。我们的目的是评估有/没有基于电子病历(EMRs)的实时自动警报系统(AAS)的RRS实施的激活模式和结果。方法:回顾性分析某三级大学附属医院外科病房激活RRS的患者的临床资料。我们比较了采用RRS和AAS前后的编码率、住院死亡率、非计划重症监护病房(ICU)入院率和其他临床结果:RRS前(2013年1月- 2015年7月)、不采用AAS的RRS(2015年8月- 2016年11月)和采用AAS的RRS(2016年12月- 2017年12月)。结果:实施RRS后,每1000名住院患者的住院死亡率从15.1降至12.9 (p)。早期发现和干预RRS可以改善患者的预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Incorporating a real-time automatic alerting system based on electronic medical records could improve rapid response systems: a retrospective cohort study.

Incorporating a real-time automatic alerting system based on electronic medical records could improve rapid response systems: a retrospective cohort study.

Incorporating a real-time automatic alerting system based on electronic medical records could improve rapid response systems: a retrospective cohort study.

Incorporating a real-time automatic alerting system based on electronic medical records could improve rapid response systems: a retrospective cohort study.

Background: Rapid response systems (RRSs) are essential components of patient safety systems; however, limited evidence exists regarding their effectiveness and optimal structures. We aimed to assess the activation patterns and outcomes of RRS implementation with/without a real-time automatic alerting system (AAS) based on electronic medical records (EMRs).

Methods: We retrospectively analyzed clinical data of patients for whom the RRS was activated in the surgical wards of a tertiary university hospital. We compared the code rate, in-hospital mortality, unplanned intensive care unit (ICU) admission, and other clinical outcomes before and after applying RRS and AAS as follows: pre-RRS (January 2013-July 2015), RRS without AAS (August 2015-November 2016), and RRS with AAS (December 2016-December 2017).

Results: In-hospital mortality per 1000 admissions decreased from 15.1 to 12.9 after RRS implementation (p < 0.001). RRS activation per 1000 admissions increased from 14.4 to 26.3 after AAS implementation. The severity of patients' condition calculated using the modified early warning score increased from 2.5 (± 2.1) in the RRS without AAS to 3.6 (± 2.1) (p < 0.001) in the RRS with AAS. The total and preventable code rates and in-hospital mortality rates were comparable between the RRS implementation periods without/with AAS. ICU duration and mortality results improved in patients with RRS activation and unplanned ICU admission. The data of RRS non-activated group remained unaltered during the study.

Conclusions: Real-time AAS based on EMRs might help identify unstable patients. Early detection and intervention with RRS may improve patient outcomes.

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