防止严重药物过敏警报被覆盖倡议:已实施的系统升级。

IF 3.5 3区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Journal of Medical Systems Pub Date : 2024-10-08 DOI:10.1007/s10916-024-02116-5
Laila Carolina Abu Esba, Samar Al Moaiseib, Norah Saud BinSabbar, Ghada Hussain Salamah Al Mardawi, Mufareh Alkatheri, Saleh Al Dekhail
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引用次数: 0

摘要

给有药物过敏反应(DHR)记录的患者用药会带来很大的不良事件风险,轻则出现不良反应,重则危及生命。电子医疗系统已彻底改变了现代临床决策过程,并内置了警告功能。然而,当这些警报成为医疗服务提供者工作流程的常规部分时,警报疲劳就成为了一项挑战。这项研究是在沙特阿拉伯的政府医疗保健系统--国民卫队卫生事务部(MNGHA)内进行的。他们成立了一个专家工作组,负责开发一种电子路径,以防止无意中覆盖严重药物过敏警报。该系统经过了严格的测试,并建立了监控参数。我们概述了系统升级的实施情况,该系统旨在触发计算机化医嘱输入 (CPOE) 过程中的另一种中断,有别于常规的过敏弹出警报。当 CPOE 中出现药物之间的匹配和有记录的严重药物过敏症状时,就会启动替代路径,需要另一位开处方者共同签字后才能继续。所采用的升级是一种积极主动的方法,可提高电子医疗保健系统的用药安全,确保与严重过敏相关的警告不会被覆盖,从而最终提高患者的安全。进一步的监测将证实这项措施的安全性和有效性。这项研究为医疗机构预防患者过敏相关伤害提供了一个范例。
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Preventing Overrides of Severe Drug Allergy Alerts Initiative: an Implemented System Upgrade.

Administering medications to patients with documented drug hypersensitivity reactions (DHR) poses a significant risk for adverse events, ranging from mild reactions to life-threatening incidents. Electronic healthcare systems have revolutionized the modern clinical decision-making process, with built in warnings. However, as these alerts become a routine part of healthcare provider's workflow, alert fatigue becomes a challenge. This study was conducted within the Ministry of National Guard Health Affairs (MNGHA), a government healthcare system in Saudi Arabia. A taskforce of experts was formed to develop an electronic path that would prevent unintentional overrides of severe drug allergy alerts. The system underwent rigorous testing, and monitoring parameters were established. We outline the implementation of a system upgrade designed to trigger an alternative interruption in the computerized physician order entry (CPOE) process, distinct from the regular allergy pop-up alerts. The alternate path is activated upon a CPOE with a drug-to-drug match and a documented severe drug allergy symptom, necessitating co-signature form another prescriber before proceeding. The adopted upgrade is a proactive approach to enhance medication safety in electronic healthcare systems, ensuring that serious allergy-related warnings are not overridden, ultimately enhancing patient safety. Further monitoring will confirm the safety and effectiveness of this measure. This study provides a model for institutions seeking to prevent allergy-related harm within their patient population.

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来源期刊
Journal of Medical Systems
Journal of Medical Systems 医学-卫生保健
CiteScore
11.60
自引率
1.90%
发文量
83
审稿时长
4.8 months
期刊介绍: Journal of Medical Systems provides a forum for the presentation and discussion of the increasingly extensive applications of new systems techniques and methods in hospital clinic and physician''s office administration; pathology radiology and pharmaceutical delivery systems; medical records storage and retrieval; and ancillary patient-support systems. The journal publishes informative articles essays and studies across the entire scale of medical systems from large hospital programs to novel small-scale medical services. Education is an integral part of this amalgamation of sciences and selected articles are published in this area. Since existing medical systems are constantly being modified to fit particular circumstances and to solve specific problems the journal includes a special section devoted to status reports on current installations.
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