Do clinicians use online evidence to support patient care? A study of 55,000 clinicians
Do clinicians use online evidence to support patient care? A study of 55,000 clinicians
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DOI：
10.1197/jamia.m1385
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发表时间：
2004-03-01
影响因子：
6.4
通讯作者：
Coiera, E
中科院分区：
文献类型：
--
作者：
Westbrook, JI;Gosling, AS;Coiera, E
目的：为了确定临床医生的（医生、护士和专职医疗人员）“实际”和“报告”使用床旁在线信息检索系统;并通过检验两个假设来评估使用与直接患者护理相关的程度：假设1：临床医生主要使用在线证据来支持与直接患者护理相关的临床决策;假设2：临床医生使用在线证据主要用于研究和继续教育。设计：临床信息访问程序（CIAP），一个在线，24小时，即时信息检索系统，可供55,000名临床医生在澳大利亚新南威尔士州的公立医院的网络日志分析。一项全州范围内的5，511名临床医生的邮件调查。测量：该州和81家研究医院每100名临床医生的在线证据搜索率;临床医生通过自填问卷报告使用CIAP;证据搜索与患者入院之间的相关性。结果：每100名临床医生每月进行48.5次“检索会话”，每100名临床医生对单一来源数据库进行231.6次文本点击（n = 619 545）; 63%的临床医生报告说，他们知道CIAP，75%的人使用过它。88%的用户报告说，CIAP有潜力改善病人护理，41%的用户报告说，报告了这方面的直接经验。临床医生每周每天使用CIAP与患者入院高度正相关（r = 0.99，p < 0.001）。这也是真实的所有十个随机选择的hospital.Conclusion：临床医生的在线证据的使用增加与病人入院，支持的假设，临床医生的证据的使用与直接的病人护理。证据使用模式和临床医生的自我报告也支持这一假设。
Objectives: To determine clinicians' (doctors', nurses', and allied health professionals') "actual" and "reported" use of a point-of-care online information retrieval system; and to make an assessment of the extent to which use is related to direct patient care by testing two hypotheses: hypothesis 1: clinicians use online evidence primarily to support clinical decisions relating to direct patient care; and hypothesis 2: clinicians use online evidence predominantly for research and continuing education.Design: Web-log analysis of the Clinical Information Access Program (CIAP), an online, 24-hour, point-of-care information retrieval system available to 55,000 clinicians in public hospitals in New South Wales, Australia. A statewide mail survey of 5,511 clinicians.Measurements: Rates of online evidence searching per 100 clinicians for the state and for the 81 individual hospitals studied; reported use of CIAP by clinicians through a self-administered questionnaire; and correlations between evidence searches and patient admissions.Results: Monthly rates of 48.5 "search sessions" per 100 clinicians and 231.6 text hits to single-source databases per 100 clinicians (n = 619,545); 63% of clinicians reported that they were aware of CIAP and 75% of those had used it. Eighty-eight percent of users reported CIAP had the potential to improve patient care and 41% reported direct experience of this. Clinicians' use of CIAP on each day of the week was highly positively correlated with patient admissions (r = 0.99, p < 0.001). This was also true for all ten randomly selected hospitals.Conclusion: Clinicians' online evidence use increases with patient admissions, supporting the hypothesis that clinicians' use of evidence is related to direct patient care. Patterns of evidence use and clinicians' self-reports also support this hypothesis.