Abstract:
BACKGROUND:Sepsis is a serious medical condition that can lead to organ dysfunction and death. Research shows that each hour delay in antibiotic administration increases mortality. The Surviving Sepsis Campaign Bundles created standards to assist in the timely treatment of patients with suspected sepsis to improve outcomes and reduce mortality. OBJECTIVE:This article determines if the use of an electronic physician order-set decreases time to antibiotic ordering for patients with sepsis in the emergency department (ED). METHODS:A retrospective chart review was performed on adult patients who presented to the ED of four community hospitals from May to July 2016. Patients with severe sepsis and/or septic shock were included. Primary outcome was the difference in time to antibiotic ordering in patients whose physicians utilized the order-set versus those whose physicians did not. Secondary outcomes included differences in time to antibiotic administration, time to lactate test, hospital length of stay, and posthospitalization disposition. The institution's Quality Improvement Committee approved the project. RESULTS:Forty-five of 123 patients (36.6%) with sepsis had physicians who used the order-set. Order-set utilization reduced the mean time to ordering antibiotics by 20 minutes (99 minutes, 95% confidence interval [CI]: 69-128 vs. 119 minutes, 95% CI: 91-147), but this finding was not statistically significant. Mean time to antibiotic administration (145 minutes, 95% CI: 108-181 vs. 182 minutes, 95% CI: 125-239) and median time to lactate tests (12 minutes, 95% CI: 0-20 vs. 19 minutes, 95% CI: 8-34), although in the direction of the hypotheses, were not significantly different. CONCLUSION:Utilization of the order-set was associated with a potentially clinically significant, but not statistically significant, reduced time to antibiotic ordering in patients with sepsis. Electronic order-sets are a promising tool to assist hospitals with meeting the Centers for Medicare and Medicaid Services core measure.
journal_name
Appl Clin Informjournal_title
Applied clinical informaticsauthors
Fargo EL,D'Amico F,Pickering A,Fowler K,Campbell R,Baumgartner Mdoi
10.1055/s-0038-1676040subject
Has Abstractpub_date
2018-10-01 00:00:00pages
869-874issue
4issn
1869-0327journal_volume
9pub_type
杂志文章,多中心研究abstract:BACKGROUND: Electronic health records (EHRs) are used in long-term care to document the patients' condition, medication, and care, thereby supporting communication among caregivers and counteracting adverse drug events. However, the use of EHRs in long-term care has lagged behind EHR use in hospitals. In addition, most...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0040-1721013
更新日期:2021-01-01 00:00:00
abstract:BACKGROUND:UW Medicine was one of the first health systems to encounter and treat COVID-19 patients in the United States, starting in late February 2020. OBJECTIVE:Here we describe the rapid rollout of capabilities by UW Medicine Information Technology Services (ITS) to support our clinical response to the COVID-19 pa...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0040-1709715
更新日期:2020-03-01 00:00:00
abstract:BACKGROUND:High-quality clinical data and biological specimens are key for medical research and personalized medicine. The Biobanking and Biomolecular Resources Research Infrastructure-European Research Infrastructure Consortium (BBMRI-ERIC) aims to facilitate access to such biological resources. The accompanying ADOPT...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0039-1695793
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND:The assessment of user preferences for performance characteristics of patient-oriented clinical prediction models is lacking. It is unknown if complex statistical aspects of prediction models are readily understandable by a general audience. OBJECTIVE:A pilot study was conducted among nonclinical audiences ...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0038-1669457
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:We previously demonstrated that a general purpose text mining system, the Vaccine adverse event Text Mining (VaeTM) system, could be used to automatically classify reports of an-aphylaxis for post-marketing safety surveillance of vaccines. OBJECTIVE:To evaluate the ability of VaeTM to classify reports to th...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2012-11-RA-0049
更新日期:2013-02-27 00:00:00
abstract:BACKGROUND:Secure clinical messaging and document exchange utilizing the Direct Protocol (Direct interoperability) has been widely implemented in health information technology (HIT) applications including electronic health records (EHRs) and by health care providers and organizations in the United States. While Direct ...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0038-1637007
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:The traditional concept of personalized nutrition is based on adapting diets according to individual needs and preferences. Discussions about personalized nutrition have been on since the Human Genome Project, which has sequenced the human genome. Thenceforth, topics such as nutrigenomics have been assessed ...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0038-1635115
更新日期:2018-01-01 00:00:00
abstract::Objective Patient instructions are generally written by clinicians. However, clinician-centered language is challenging for patients to understand; in the case of pediatric medication instructions, consequences can be serious. Using examples of clinician-written medication instructions from an electronic health record...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2017-06-RA-0111
更新日期:2017-10-01 00:00:00
abstract:OBJECTIVE:Based on US. Centers for Disease Control and Prevention recommendations, New York State enacted legislation in 2010 requiring healthcare providers to offer non-targeted human immunodeficiency virus (HIV) testing to all patients aged 13-64. Three New York City adult emergency departments implemented an electro...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2013-09-RA-0075
更新日期:2014-03-26 00:00:00
abstract:OBJECTIVES:Unwarranted variance in healthcare has been associated with prolonged length of stay, diminished health and increased cost. Practice variance in the management of asthma can be significant and few investigators have evaluated strategies to reduce this variance. We hypothesized that selective redesign of orde...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2011-01-RA-0002
更新日期:2012-02-08 00:00:00
abstract:OBJECTIVE:To evaluate the health information technology (HIT) workforce knowledge and skills needed by HIT employers. METHODS:Statewide face-to-face and online focus groups of identified HIT employer groups in Austin, Brownsville, College Station, Dallas, El Paso, Houston, Lubbock, San Antonio, and webinars for rural ...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2012-09-RA-0035
更新日期:2012-12-05 00:00:00
abstract:BACKGROUND:In 2013, the American College of Cardiology (ACC) and the American Heart Association (AHA) released a revised guideline on statin therapy initiation. The guideline included a 10-year risk calculation based on regression modeling, which made hand calculation infeasible. Compliance to the guideline has been su...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0039-1692186
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND: Prediabetes and type 2 diabetes mellitus (T2DM) are one of the major long-term health conditions affecting global healthcare delivery. One of the few effective approaches is to actively manage diabetes via a healthy and active lifestyle. OBJECTIVES: This research is focused on early detection of prediabete...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0040-1719043
更新日期:2021-01-01 00:00:00
abstract:OBJECTIVES:Transitions in patient care pose an increased risk to patient safety. One way to reduce this risk is to ensure accurate medication reconciliation during the transition. Here we present an evaluation of an electronic medication reconciliation module we developed to reduce the transition risk in patients refer...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2015-11-RA-0154
更新日期:2016-05-25 00:00:00
abstract:OBJECTIVE:To understand how clinicians utilize image uploading tools in a home grown electronic health records (EHR) system. METHODS:A content analysis of patient notes containing non-radiological images from the EHR was conducted. Images from 4,000 random notes from July 1, 2009 - June 30, 2010 were reviewed and manu...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2016-10-RA-0180
更新日期:2017-07-12 00:00:00
abstract:BACKGROUND:While evidence generally supports the use of medication management technology, systems are typically implemented and evaluated piecemeal rather than as part of a comprehensive model for medication management. Systems to support drug therapy optimization, increasingly a key role of pharmacists in our healthca...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0037-1620262
更新日期:2018-01-01 00:00:00
abstract:BACKGROUND:Asthma exacerbations are one of the most common medical reasons for children to be brought to the hospital emergency department (ED). Various prediction models have been proposed to support diagnosis of exacerbations and evaluation of their severity. OBJECTIVES:First, to evaluate prediction models construct...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2013-04-RA-0029
更新日期:2013-08-07 00:00:00
abstract:BACKGROUND:Semantic interoperability between routine healthcare and clinical research is an unsolved issue, as information systems in the healthcare domain still use proprietary and site-specific data models. However, information exchange and data harmonization are essential for physicians and scientists if they want t...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2012-03-RA-0011
更新日期:2012-07-11 00:00:00
abstract:OBJECTIVE:The use of text messaging in clinical care has become ubiquitous. Due to security and privacy concerns, many hospital systems are evaluating secure text messaging applications. This paper highlights our evaluation process, and offers an overview of secure messaging functionalities, as well as a framework for ...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0039-1678607
更新日期:2019-01-01 00:00:00
abstract::Web 2.0 technologies, known as social media, social technologies or Web 2.0, have emerged into the mainstream. As they grow, these new technologies have the opportunity to influence the methods and procedures of many fields. This paper focuses on the clinical implications of the growing Web 2.0 technologies. Five deve...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2010-01-CR-0003
更新日期:2010-04-21 00:00:00
abstract:BACKGROUND:A structured report for imaging exams aims at increasing the precision in information retrieval and communication between physicians. However, it is more concise than free text and may limit specialists' descriptions of important findings not covered by pre-defined structures. A computational ontological str...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2016-03-RA-0037
更新日期:2016-08-24 00:00:00
abstract:BACKGROUND: Poor self-management of heart failure (HF) has contributed to poor health outcomes. Sensor-controlled digital games (SCDGs) integrates data from behavior-tracking sensors to trigger progress, rewards, content, and positive feedback in a digital game to motivate real-time behaviors. OBJECTIVES: To assess th...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0040-1721399
更新日期:2020-10-01 00:00:00
abstract:: ...
journal_title:Applied clinical informatics
pub_type: 社论
doi:10.1055/s-0038-1676332
更新日期:2018-10-01 00:00:00
abstract:OBJECTIVES:More patients are receiving their test results via patient portals. Given test results are written using medical jargon, there has been concern that patients may misinterpret these results. Using sample colonoscopy and Pap smear results, our objective was to assess how frequently people can identify the corr...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0039-1679960
更新日期:2019-03-01 00:00:00
abstract:BACKGROUND:Advances in technology and access to expanded genetic testing have resulted in more children and adolescents receiving genetic testing for diagnostic and prognostic purposes. With increased adoption of the electronic health record (EHR), genetic testing is increasingly resulted in the EHR. However, this lead...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0040-1718753
更新日期:2020-10-01 00:00:00
abstract:BACKGROUND:Electronic health record (EHR)-based registries allow for robust data to be derived directly from the patient clinical record and can provide important information about processes of care delivery and patient health outcomes. METHODS:A data dictionary, and subsequent data model, were developed describing EH...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.1055/s-0038-1651496
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:Kidney disease is under-documented in physician notes. The use of template-guided notes may improve physician recognition of kidney disease early in training. OBJECTIVE:The objective of this study was to determine whether a computerized inpatient renal template note with clinical decision support improves r...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2013-07-RA-0048
更新日期:2013-11-13 00:00:00
abstract:UNLABELLED:Nationwide Children's Hospital established an i2b2 (Informatics for Integrating Biology & the Bedside) application for sleep disorder cohort identification. Discrete data were gleaned from semistructured sleep study reports. The system showed to work more efficiently than the traditional manual chart review ...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2014-11-RA-0106
更新日期:2015-05-27 00:00:00
abstract:BACKGROUND:Homecare is an important and effective way of managing chronic illnesses using skilled nursing care in the home. Unlike hospitals and ambulatory settings, clinicians visit patients at home at different times, independent of each other. Twenty-nine percent of 10,000 homecare agencies in the United States have...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2013-12-RA-0106
更新日期:2014-04-30 00:00:00
abstract:OBJECTIVE:1. To conduct a review of the role of informatics in pediatric disaster preparedness using all medical databases. 2. To provide recommendations to improve pediatric disaster preparedness by the application of informatics. METHODS:A literature search was conducted using MEDLINE, CINHL and the Cochrane Library...
journal_title:Applied clinical informatics
pub_type: 杂志文章
doi:10.4338/ACI-2009-12-R-0019
更新日期:2010-08-04 00:00:00