@Article{info:doi/10.2196/26946，作者=“Lee, Andy hong - yi and Aaronson, Emily and Hibbert, Kathryn A and Flynn, Micah H and Rutkey, Hayley and Mort, Elizabeth and Sonis, Jonathan D and Safavi, Kyan C”，标题=“急诊脓毒症实时监测平台的设计与实现:观察队列研究”，期刊=“J Med Internet Res”，年=“2021”，月=“6”，日=“24”，卷=“23”，号=“6”，页=“e26946”，关键词=“电子监测平台;脓毒症;背景:败血症是美国医院死亡的主要原因。依从捆绑护理，特别是系列乳酸、血培养和抗生素，改善了结果，但在繁忙的实践环境中往往被推迟或完全错过。目的:本研究旨在设计、实施和验证一种新的监测和警报平台，该平台可以向一线急诊科(ED)提供者提供关于捆绑治疗依从性的实时反馈。方法:该单中心前瞻性观察性研究分三个阶段进行:设计和技术开发阶段，构建平台的初始版本;在临床环境中测试和完善平台的试点阶段;并在试点后的推广阶段全面实施研究干预。结果:在设计和技术开发过程中，研究团队成员和利益相关者确定了患者纳入的标准，从医疗保险和医疗补助败血症核心措施中心选择了用于警报的捆绑措施，并定义了警报阈值、消息内容、传递机制和接收者。 Additional refinements were made based on 70 provider survey results during the pilot phase, including removing alerts for vasopressor initiation and modifying text in the pages to facilitate patient identification. During the 48 days of the postpilot rollout phase, 15,770 ED encounters were tracked and 711 patient encounters were included in the active monitoring cohort. In total, 634 pages were sent at a rate of 0.98 per attending physician shift. Overall, 38.3{\%} (272/711) patients had at least one page. The missing bundle elements that triggered alerts included: antibiotics 41.6{\%} (136/327), repeat lactate 32.4{\%} (106/327), blood cultures 20.8{\%} (68/327), and initial lactate 5.2{\%} (17/327). Of the missing Sepsis Core Measures elements for which a page was sent, 38.2{\%} (125/327) were successfully completed on time. Conclusions: A real-time sepsis care monitoring and alerting platform was created for the ED environment. The high proportion of patients with at least one alert suggested the significant potential for such a platform to improve care, whereas the overall number of alerts per clinician suggested a low risk of alarm fatigue. The study intervention warrants a more rigorous evaluation to ensure that the added alerts lead to better outcomes for patients with sepsis. ", issn="1438-8871", doi="10.2196/26946", url="//www.mybigtv.com/2021/6/e26946/", url="https://doi.org/10.2196/26946", url="http://www.ncbi.nlm.nih.gov/pubmed/34185009" }