Delay Between Actual Occurrence of Patient Vital Sign and the Nominal Appearance in the Electronic Health Record: Single-Center, Retrospective Study of PICU Data, 2014-2018.
Delay Between Actual Occurrence of Patient Vital Sign and the Nominal Appearance in the Electronic Health Record: Single-Center, Retrospective Study of PICU Data, 2014-2018.
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患者生命体征的实际出现与电子健康记录中的标称出现之间的延迟：2014-2018 年 PICU 数据的单中心回顾性研究。
DOI：
10.1097/pcc.0000000000003398
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发表时间：
2024
期刊：
影响因子：
--
通讯作者：
Perotte,Adler
中科院分区：
文献类型：
--
作者：
SchlosserMetitiri,KatherineR;Perotte,Adler
电子健康记录(EHR)中绘制的患者生命体征数据用于时间敏感的决策，但与实际测量生命体征时相比，人们对这些数据何时名义上可用知之甚少。这项研究的目的是确定从患者实际测量生命体征到名义上出现在EHR中的任何延迟的大小。我们进行了一项单中心回顾性队列研究。高等学府儿童医院。从2014年1月到2018年12月，共有5458名患者住进了PICU。没有。我们分析了所有进入EHR的生命体征的进入和显示时间。主要的结果测量是在EHR中生命体征出现和生命体征的标称时间之间的时间。另一项结果测量是批次图表的频率。在研究期间，总共记录了9818,901次生命体征。在整个队列中，EHR中发生时间与标称时间之间的中位数(四分位数范围[IQR])相差小时：分：秒，00：41：58(IQR 00：13：42-01：44：10)。PICU入院前24小时的滞后时间为00：47：34(IQR 00：15：23-02：19：00)，后24小时的滞后时间为00：38：49(IQR 00：13：09-01：29：22；P<；0.001)。批次图出现1,892,143次。这项回顾研究表明，生命体征的出现与其在电子病历中的出现之间存在滞后，以及批次图表的频繁实践。延迟的程度--中位数约40分钟--表明EHR中可用于临床审查和纳入临床警报的生命体征在可用时可能已过时。
Patient vital sign data charted in the electronic health record (EHR) are used for time-sensitive decisions, yet little is known about when these data become nominally available compared with when the vital sign was actually measured. The objective of this study was to determine the magnitude of any delay between when a vital sign was actually measured in a patient and when it nominally appears in the EHR. We performed a single-center retrospective cohort study. Tertiary academic children's hospital. A total of 5,458 patients were admitted to a PICU from January 2014 to December 2018. None. We analyzed entry and display times of all vital signs entered in the EHR. The primary outcome measurement was time between vital sign occurrence and nominal timing of the vital sign in the EHR. An additional outcome measurement was the frequency of batch charting. A total of 9,818,901 vital sign recordings occurred during the study period. Across the entire cohort the median (interquartile range [IQR]) difference between time of occurrence and nominal time in the EHR was in hours: minutes: seconds, 00: 41: 58 (IQR 00: 13: 42-01: 44: 10). Lag in the first 24 hours of PICU admission was 00: 47: 34 (IQR 00: 15: 23-02: 19: 00), lag in the last 24 hours was 00: 38: 49 (IQR 00: 13: 09-01: 29: 22; p< 0.001). There were 1,892,143 occurrences of batch charting. This retrospective study shows a lag between vital sign occurrence and its appearance in the EHR, as well as a frequent practice of batch charting. The magnitude of the delay-median~ 40 minutes-suggests that vital signs available in the EHR for clinical review and incorporation into clinical alerts may be outdated by the time they are available.