Crit Care:病房患者临床恶化的自动通知系统对其临床结局有何影响?

2017-03-20 xing.T MedSci原创

由此可见,部署电子自动咨询生命体征监测和通知来系统传递病房患者临床恶化,可以显著改善以病人为中心的重要临床结局。

在病房患者发生临床恶化时医务人员反应延迟的现象是很常见的。近日,危重病医学领域权威杂志Critical Care上针对这一问题发表了一篇研究文章。

研究人员在英国的一个区域总医院的两个临床病房进行了一项前瞻性研究。研究人员在这项研究中评估了使用电子自动咨询生命体征监测和通知系统对患者临床结局的影响,该系统可以将患者异常的生命体征传递给快速反应团队(RRT)。

研究人员分析了干预前的2139例患者(对照组)和干预后的2263例患者。在干预期间,通知RRT的数量从405次提高到了524次(P= 0.001),并且通知导致了更多的液体、支气管扩张剂和抗生素治疗。此外,尽管通知“不尝试复苏”指令的病人数量有所增加(从99例增加到135例;P=0.047),死亡率从173例下降到了147例(P=0.042)患者,心脏骤停事件从14次下降到了2次(P=0.002)。最后,患者入住ICU时的病情严重程度的降低(平均急性生理和慢性健康评估II评分:26(SD为9) vs. 18(SD为8)),他们的死亡率也降低(从45%下降到了24%;P=0.04)。

由此可见,部署电子自动咨询生命体征监测和通知来系统传递病房患者临床恶化,可以显著改善以病人为中心的重要临床结局。

原始出处:

Christian P. Subbe, et al. Effect of an automated notification system for deteriorating ward patients on clinical outcomes.Critical Care.2017. http://ccforum.biomedcentral.com/articles/10.1186/s13054-017-1635-z

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    2017-03-25 love0711172

    还是这个

    0

  4. 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createdName=yeaweam, createdTime=Fri Oct 27 10:02:00 CST 2017, time=2017-10-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=182541, encodeId=12d318254102, content=还是这个, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/03/02/0986bbe0ac931229732ed9c7a17e5467.jpg, createdBy=9c892011128, createdName=love0711172, createdTime=Sat Mar 25 07:04:38 CST 2017, time=2017-03-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=182408, encodeId=a63f18240847, content=新闻更新慢, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/03/02/0986bbe0ac931229732ed9c7a17e5467.jpg, 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authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLANEL7Sww3HicKsN9aribicAmGGWXOIMEiaZ1iadgZg9RibjqSwIKUS8gSPib2NwTVg2zVvVJhdP3BkuDIl/0, createdBy=944d1605392, createdName=shaosai, createdTime=Tue Mar 21 08:51:38 CST 2017, time=2017-03-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=181613, encodeId=8fd71816137b, content=谢谢分享,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Tue Mar 21 08:25:04 CST 2017, time=2017-03-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=181600, encodeId=aa01181600cd, content=文章很好,值得分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Mar 21 08:11:32 CST 2017, time=2017-03-21, status=1, ipAttribution=)]
    2017-03-24 love0711172

    新闻更新慢

    0

  5. 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likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Mar 21 08:11:32 CST 2017, time=2017-03-21, status=1, ipAttribution=)]
    2017-03-23 love0711172

    目前中国都没有该系统

    0

  6. 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authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLANEL7Sww3HicKsN9aribicAmGGWXOIMEiaZ1iadgZg9RibjqSwIKUS8gSPib2NwTVg2zVvVJhdP3BkuDIl/0, createdBy=944d1605392, createdName=shaosai, createdTime=Tue Mar 21 08:51:38 CST 2017, time=2017-03-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=181613, encodeId=8fd71816137b, content=谢谢分享,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Tue Mar 21 08:25:04 CST 2017, time=2017-03-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=181600, encodeId=aa01181600cd, content=文章很好,值得分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Mar 21 08:11:32 CST 2017, time=2017-03-21, status=1, ipAttribution=)]
    2017-03-22 love0711172

    希望不错

    0

  7. 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authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLANEL7Sww3HicKsN9aribicAmGGWXOIMEiaZ1iadgZg9RibjqSwIKUS8gSPib2NwTVg2zVvVJhdP3BkuDIl/0, createdBy=944d1605392, createdName=shaosai, createdTime=Tue Mar 21 08:51:38 CST 2017, time=2017-03-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=181613, encodeId=8fd71816137b, content=谢谢分享,学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6Nx0VGA4QMDzOP8oAgnV4h51EjSfehJ9QxyiaSmw8PB56BhY8KXFSxHCibXrzcy4abrzSibXQPxJ9kzrLcJyhhB8a/0, createdBy=1d3b1672603, createdName=明月清辉, createdTime=Tue Mar 21 08:25:04 CST 2017, time=2017-03-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=181600, encodeId=aa01181600cd, content=文章很好,值得分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Mar 21 08:11:32 CST 2017, time=2017-03-21, status=1, ipAttribution=)]
    2017-03-21 ren1mw

    新方式,新概念,什么时候能尝试一下下就好了

    0

  8. 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likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Mar 21 08:11:32 CST 2017, time=2017-03-21, status=1, ipAttribution=)]
    2017-03-21 shaosai

    好好学习,涨知识

    0

  9. 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likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Mar 21 08:11:32 CST 2017, time=2017-03-21, status=1, ipAttribution=)]
    2017-03-21 明月清辉

    谢谢分享,学习了

    0

  10. 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likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Tue Mar 21 08:11:32 CST 2017, time=2017-03-21, status=1, ipAttribution=)]
    2017-03-21 1e10c84am36(暂无匿称)

    文章很好,值得分享

    0