Impact of electronic-alerting of acute kidney injury: workgroup statements from the 15(th) ADQI Consensus Conference.
Impact of electronic-alerting of acute kidney injury: workgroup statements from the 15(th) ADQI Consensus Conference.
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DOI：
10.1186/s40697-016-0101-1
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发表时间：
2016-01-01
影响因子：
1.7
通讯作者：
Bagshaw, Sean M
中科院分区：
文献类型：
--
作者：
Hoste, Eric A J;Kashani, Kianoush;Bagshaw, Sean M
综述的目的：在住院患者中，急性肾损伤很常见，并与显著的发病率和死亡风险相关。在过去的十年中，使用电子健康记录（EHR）来预测和检测这种重要的临床综合征已经有所增长。第15届急性透析质量倡议（ADQI）会议的指导委员会专门制定了一项任务，即确定可能影响急性肾损伤（阿基）电子警报后事件过程的要素。信息来源：在广泛的非系统性文献检索后，我们使用了改良的德尔菲方法，就阿基电子警报的使用的几个方面达成了共识。本报告讨论的主题包括循证实践的进展、最佳电子警报的特征、疗效和有效性的衡量标准，以及阿基电子警报后哪些应对措施被视为最佳实践。作者得出结论，目前电子警报系统有效性的证据虽然在增加，但仍然不足。技术和与人有关的因素被认为是今后任何调查或使用这些工具的关键因素。专家组还得出结论认为，如果没有一项有力的计划来评估电子警报的功效和效力，就不应实施这种系统。电子警报的功效和有效性应根据具体情况和患者结局来衡量。最后，该小组提出了几项建议，应考虑以下成功的电子警报implementation.LIMITED的临床决策支持：本文反映了一个非系统性的审查和专家意见的调查结果。
PURPOSE OF THE REVIEW: Among hospitalized patients, acute kidney injury is common and associated with significant morbidity and risk for mortality. The use of electronic health records (EHR) for prediction and detection of this important clinical syndrome has grown in the past decade. The steering committee of the 15(th) Acute Dialysis Quality Initiative (ADQI) conference dedicated a workgroup with the task of identifying elements that may impact the course of events following Acute Kidney Injury (AKI) e-alert.SOURCES OF INFORMATION: Following an extensive, non-systematic literature search, we used a modified Delphi process to reach consensus regarding several aspects of the utilization of AKI e-alerts.FINDINGS: Topics discussed in this workgroup included progress in evidence base practices, the characteristics of an optimal e-alert, the measures of efficacy and effectiveness, and finally what responses would be considered best practices following AKI e-alerts. Authors concluded that the current evidence for e-alert system efficacy, although growing, remains insufficient. Technology and human-related factors were found to be crucial elements of any future investigation or implementation of such tools. The group also concluded that implementation of such systems should not be done without a vigorous plan to evaluate the efficacy and effectiveness of e-alerts. Efficacy and effectiveness of e-alerts should be measured by context-specific process and patient outcomes. Finally, the group made several suggestions regarding the clinical decision support that should be considered following successful e-alert implementation.LIMITATIONS: This paper reflects the findings of a non-systematic review and expert opinion.IMPLICATIONS: We recommend implementation of the findings of this workgroup report for use of AKI e-alerts.