Examining Nursing Home Information Technology Maturity and Antibiotic Use Among Long-Term Care Residents.
Examining Nursing Home Information Technology Maturity and Antibiotic Use Among Long-Term Care Residents.
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DOI：
10.1016/j.jamda.2022.01.052
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发表时间：
2022-06
影响因子：
7.6
通讯作者：
Alexander, Gregory L.
中科院分区：
文献类型：
--
作者：
Cohen, Catherine C.;Powell, Kimberly;Dick, Andrew W.;Deroche, Chelsea B.;Agarwal, Mansi;Stone, Patricia W.;Alexander, Gregory L.
在140万美国疗养院(NH)居民中，每天接受抗生素治疗的比例高达15%。在NHS中使用抗生素往往是不合适的，这导致了质量和安全问题以及抗生素耐药性。信息技术(IT)成熟度被定义为机构拥有和使用各种技术设备和软件的程度，这些设备和软件集成在居民护理、临床支持和行政活动中，可能会改善NH居民抗生素使用的跟踪和报告。因此，这项研究探索了随着时间的推移信息技术成熟度的趋势以及与美国NHS中抗生素使用的关系。连续四年(2013-2017)对经过Medicare认证的美国NHS进行的随机抽样的长期居民评估的重复横断面研究使用了三个数据源：1)衡量IT成熟度的四项年度调查；2)针对居民特征的最小数据集(MDS)3.0评估；以及3)认证和调查提供商增强了设施特征的报告数据。在IT调查的90天窗口内的非准入MDS评估符合条件。对描述性统计进行了检验。利用NH固定效应进行二元和多元回归，控制居民特征和NH特征。来自817个NHS的80,237名65岁以上的长期居民进行了219,461项MDS评估。IT成熟度的趋势在4年内显著增加。行政流程中信息技术的整合与抗生素使用呈正相关(AOR：1.072，95%CI：1.025，1.122)。整合管理活动的IT组成部分与抗生素使用的变化有关，这些活动可以作为一个整体提供对整个组织数据源的更大访问。需要进一步的评估，以确定抗生素的使用是否与成熟度更高更合适，以便政策制定者能够鼓励具有这些能力的IT部门促进抗生素管理。疗养院的信息技术成熟度正在提高。通过IT在整个组织中进行更多的数据访问与更多的抗生素使用相关。考虑到IT成熟度影响临床流程，它可能被用来促进管理。
Up to 15% of the 1.4 million U.S. nursing home (NH) residents receive antibiotics daily. Antibiotic use in NHs is often inappropriate, contributing to quality and safety concerns as well as antibiotic resistance. Information technology (IT) maturity, defined as the extent to which facilities possess and use diverse technological devices and software that are integrated across resident care, clinical support and administrative activities, may improve the tracking and reporting of antibiotic use in NH residents. Thus, this research explores trends in IT maturity over time and associations with antibiotic use in U.S. NHs. Repeated cross-sectional study Long-term resident assessments from a random sample of Medicare-certified U.S. NHs over four consecutive years (2013–2017) Three data sources were used 1) four annual surveys measuring IT maturity, 2) Minimum Data Set (MDS) 3.0 assessments for resident characteristics, and 3) Certification and Survey Provider Enhanced Reporting data for facility characteristics. Non-admission MDS assessments that were within a 90 day window of the IT survey were eligible. Descriptive statistics were examined. Bivariate and multivariate regressions using NH fixed effects were conducted controlling for resident and NH characteristics. There were 219,461 MDS assessments from 80,237 long-stay residents aged 65+ years, living in 817 NHs. Trends in IT maturity increased significantly over 4 years. IT integration in administrative processes was positively associated with antibiotic use (AOR: 1.072, 95% CI: 1.025, 1.122). IT components that integrate administrative activities, which can provide greater access to data sources across the organization as a whole, was associated with changes in antibiotic use. Further evaluation is needed to determine if antibiotic use is more appropriate with higher maturity such that policymakers can encourage IT with these capabilities to promote antibiotic stewardship. IT maturity is increasing in nursing homes. Greater data access across an organization via IT is associated with more antibiotic use. Considering that IT maturity influences clinical processes, it might be used to promote stewardship.
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DOI：
10.1016/s1386-5056(01)00178-2
发表时间：
2001-10-01
影响因子：
4.9
作者：
Paré, G;Sicotte, C
通讯作者：
Sicotte, C
DOI：
10.1093/jamia/ocw051
发表时间：
2017-01-01
影响因子：
6.4
作者：
Alexander, Gregory L.;Madsen, Richard W.;Gugerty, Brian
通讯作者：
Gugerty, Brian
影响因子：
2.5
作者：
Ojinnaka，Chinedum O.;Adepoju，Omolola E.
通讯作者：
Adepoju，Omolola E.
影响因子：
3.3
作者：
Montoya, Ana;Cassone, Marco;Mody, Lona
通讯作者：
Mody, Lona
影响因子：
5.5
作者：
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