- 學位論文
在運用高風險警示系統下評估醫師更改抗生素醫囑的時間
Effect of High Risk Results Reminder System on the Interval of Changing Antibiotics Orders in a Hospital
摘要
論文名稱：在運用高風險警示系統下評估醫師更改抗生素醫囑的時間 臺北醫學大學醫學資訊研究所 研究生姓名：陳瑋婷 畢業時間： 95 學年度 第 2 學期 指導教授：徐建業 臺北醫學大學醫學資訊研究所副教授兼所長 協同指導教授：李友專 陽明大學生物醫學資訊研究所教授兼所長 動機：許多研究調查顯示，資訊科技可以有效減少醫療失誤及不良事件比率，衛生署為推動以資訊科技協助增進病人安全，其中包含高風險警示系統(High Risk Results Reminder，HRR)建置及成效。本研究即利用微生物培養高風險警示系統的建置，評估系統的成效。 目的：分析微生物培養高風險警示系統上線前後，醫師更改抗生素醫令的處理時間差異，藉此觀察醫師行為是否於系統上線前後有縮短，以評估系統的有效性。 實驗設計：95年1~6月為系統介入實驗期，94年1~6月為未介入的對照期間。 結果：經由觀察所有微生物培養高風險檢驗結果產生後發現，系統介入後醫師更改的抗生素醫囑時間平均差77.13分鐘，統計具顯著(p=.004<0.05)。此外，當發現血液中含有微生物時，系統介入後醫師更改的抗生素醫囑時間平均差69.01分鐘，統計具顯著(p=0.010<0.05)。由於一般病房中有高風險警示，一天內之顯著性(p=0.010<0.05)，相較於加護病房之顯著性(p=0.151>0.05)有差異，此系統對於一般病房的資料顯示醫師更改抗生素醫囑時間明顯較有差異。 結論：整體而言，系統介入後，醫師更改醫囑的行為都有加快。在系統介入後，對一般病房的病人保護作用較大。
關鍵字
高風險警示系統並列摘要
Title of Thesis：Effect of High Risk Results Reminder System on the Interval of Changing Antibiotics Orders in a Hospital Author：Chen, Wei-Ting Thesis advised by ： Chien-Yeh Hsu Taipei Medical University, Graduate Institute of Medical Informatics Thesis co-advised by ： Li, Yu-Chuan National YangMing University, Institute of Biomedical Informatics Many research indicate that information technology can reduce medical errors and medical adverse events rate. The Department of Health improves patient safety by promoting information technology, including the establishment of High Risk Results Reminder System and its evaluation. This study also evaluates the effects of the establishment of High Risk Results Reminder System on the culture . Purpose：Effect of High Risk Results Reminder System on the interval of changing antibiotics orders in a hospital . Design and settings：The culture of High Risk Result Reminder System was activated in one medical center for a 6-month intervention period from January to June 2006; compared with a 6-month control period without intervention from January to June 2005. Result：When the system was set online, doctor reduced time to modify the antibiotics order. There was a significant difference after intervention (p=.004<0.05). The results of the culture in blood showed the significant difference between before and after the system online (p=0.010<0.05). In one day, the general ward there was significantly different between the system online before and after (p=0.010<0.05), but the ICU there showed no significant difference (p=0.151>0.05). Conclusions：Doctors have reduced time to modify the order after intervention of the system. The shorting of delay has proven to be more prominent in the general ward patients than in the ICU inpatients.
參考文獻
延伸閱讀
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