TY - JOUR AU - Yan, Chao AU - Zhang, Xinmeng AU - Gao, Cheng AU - Wilfong, Erin AU - Casey, Jonathan AU - France, Daniel AU - Gong, Yang AU - Patel, Mayur AU - Malin, Bradley AU - Chen, You PY - 2021 DA - 2021/3/8 TI - COVID-19重症监护合作结构:回顾性网络分析研究乔- SP JMIR哼因素e25724六世- 8 - 1 KW - COVID-19千瓦重症监护室KW -协作结构千瓦危重病人KW -医护工作者KW -网络分析KW -电子健康记录KW -协作KW -急救护理KW -关系KW -安全KW -团队合作AB -背景:一些重症监护室(ICU)人员研究了卫生保健工作者的合作结构(卫生工作者)。了解卫生保健机构如何与COVID-19危重患者的护理相联系，对于描述团队结构、护理质量和患者安全之间的关系非常重要。目的:通过比较感染新冠肺炎和未感染新冠肺炎的危重症患者的HCW合作管理，发现新冠肺炎重症监护团队结构的差异。方法:采用网络分析方法，对76例新冠肺炎危重症患者的电子病历(EHRs)进行回顾性分析(n=38;无COVID-19: n=38)，他们被大型学术医疗中心录取，并了解HCW合作。我们使用了2020年3月17日至2020年5月31日期间在范德比尔特大学医学中心(美国田纳西州纳什维尔)新冠肺炎ICU住院的成年患者的电子病历。我们根据每个病人的年龄，性别和住院时间进行匹配。2019年12月1日至2020年2月29日期间，非COVID-19患者入住医疗ICU。我们使用了两个社会计量学——特征中心性和中介性——来量化hcw在网络中的状态。 Eigencentrality characterizes the degree to which an HCW is a core person in collaboration structures. Betweenness centrality refers to whether an HCW lies on the path of other HCWs who are not directly connected. This sociometric was used to characterize HCWs’ broad skill sets. We measured patient staffing intensity in terms of the number of HCWs who interacted with patients’ EHRs. We assessed the statistical differences in the core and betweenness statuses of HCWs and the patient staffing intensities of COVID-19 and non–COVID-19 critical care, by using Mann-Whitney U tests and reporting 95% CIs. Results: HCWs in COVID-19 critical care were more likely to frequently work with each other (eigencentrality: median 0.096) than those in non–COVID-19 critical care (eigencentrality: median 0.057; P<.001). Internal medicine physicians in COVID-19 critical care had higher core statuses than those in non–COVID-19 critical care (P=.001). Nurse practitioners in COVID-19 care had higher betweenness statuses than those in non–COVID-19 care (P<.001). Compared to HCWs in non–COVID-19 settings, the EHRs of critically ill patients with COVID-19 were used by a larger number of internal medicine nurse practitioners (P<.001), cardiovascular nurses (P<.001), and surgical ICU nurses (P=.002) and a smaller number of resident physicians (P<.001). Conclusions: Network analysis methodologies and data on EHR use provide a novel method for learning about differences in collaboration structures between COVID-19 and non–COVID-19 critical care. Health care organizations can use this information to learn about the novel changes that the COVID-19 pandemic has imposed on collaboration structures in urgent care. SN - 2292-9495 UR - https://humanfactors.www.mybigtv.com/2021/1/e25724 UR - https://doi.org/10.2196/25724 UR - http://www.ncbi.nlm.nih.gov/pubmed/33621187 DO - 10.2196/25724 ID - info:doi/10.2196/25724 ER -