Impact of e-alert for detection of acute kidney injury on processes of care and outcomes: protocol for a systematic review and meta-analysis.
Impact of e-alert for detection of acute kidney injury on processes of care and outcomes: protocol for a systematic review and meta-analysis.
复制标题
检测急性肾损伤的电子警报对护理过程和结果的影响：系统评价和荟萃分析方案。
DOI：
10.1136/bmjopen-2016-011152
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发表时间：
2016
期刊：
影响因子：
2.9
通讯作者：
Bagshaw,SeanM
中科院分区：
文献类型：
--
作者：
Lachance,Philippe;Villeneuve,Pierre-Marc;Wilson,FrancisP;Selby,NicholasM;Featherstone,Robin;Rewa,Oleksa;Bagshaw,SeanM
前言急性肾损伤（阿基）是住院患者的常见并发症。它带来了严重发病率和死亡率的重大风险。此外，患有阿基发作的患者消耗相当大的卫生资源。最近，许多研究评估了从电子病历（EMR）和临床信息系统（CIS）配置的自动电子警报（e-alerts）的实施，以警告医疗保健提供者住院患者的早期或即将发生的阿基。电子警报对护理过程，病人的结果和卫生资源的使用，但是，仍然不确定的影响。方法和analysisWe将进行系统的审查，以描述和评价阿基的电子警报，并评估其对护理过程的影响，临床结果和卫生服务的使用。与研究馆员协商，制定检索策略，并检索电子数据库（即MEDLINE、EMBASE、CINAHL、科克伦图书馆和Inspec via Engineering Village）。还将检索选定的灰色文献来源。搜索主题将侧重于电子警报和阿基。引文筛选、选择、质量评估和数据提取将一式两份进行。主要分析将为叙述性分析;但是，在可行的情况下，将进行汇总分析。每一个电子警报会根据触发、警报类型、目标接收者和侵扰程度来描述。伦理和传播我们的系统性综述将综合有关电子警报检测阿基的价值及其对流程、以患者为中心的结果和资源使用的影响的文献，并确定实施的关键知识差距和障碍。这是一个更广泛的研究方案的基本步骤，该方案旨在了解电子警报的理想结构、目标人群和实施方法，以从中获益。本综述无需研究伦理批准，系统综述注册号CRD 42016033033。
IntroductionAcute kidney injury (AKI) is a common complication in hospitalised patients. It imposes significant risk for major morbidity and mortality. Moreover, patients suffering an episode of AKI consume considerable health resources. Recently, a number of studies have evaluated the implementation of automated electronic alerts (e-alerts) configured from electronic medical records (EMR) and clinical information systems (CIS) to warn healthcare providers of early or impending AKI in hospitalised patients. The impact of e-alerts on care processes, patient outcomes and health resource use, however, remains uncertain.Methods and analysisWe will perform a systematic review to describe and appraise e-alerts for AKI, and evaluate their impact on processes of care, clinical outcomes and health services use. In consultation with a research librarian, a search strategy will be developed and electronic databases (ie, MEDLINE, EMBASE, CINAHL, Cochrane Library and Inspec via Engineering Village) searched. Selected grey literature sources will also be searched. Search themes will focus on e-alerts and AKI. Citation screening, selection, quality assessment and data abstraction will be performed in duplicate. The primary analysis will be narrative; however, where feasible, pooled analysis will be performed. Each e-alert will be described according to trigger, type of alert, target recipient and degree of intrusiveness. Pooled effect estimates will be described, where applicable.Ethics and disseminationOur systematic review will synthesise the literature on the value of e-alerts to detect AKI, and their impact on processes, patient-centred outcomes and resource use, and also identify key knowledge gaps and barriers to implementation. This is a fundamental step in a broader research programme aimed to understand the ideal structure of e-alerts, target population and methods for implementation, to derive benefit. Research ethics approval is not required for this review.Systematic review registration numberCRD42016033033.