基于预警决策的重症患者非计划性拔管信息系统的设计与研发

Design and development of early warning systems for unplanned extubation in decision-making-based critical patients

目的研发重症患者非计划性拔管预警系统,对其非计划性拔管风险进行预警及干预,从而降低意外拔管风险,保障患者安全。方法以重症患者非计划性拔管风险预警指标体系模型为核心,以预防重症患者非计划性拔管护理干预方案为指导蓝本,以医院重症监护临床信息系统为基础,依托计算机信息技术,对系统的界面布局、分区、模块结构、内容和功能进行整体构架,多角度、多方位研发重症患者非计划性拔管预警系统,并用该系统回顾性分析2016年1—12月18例发生非计划性拔管案例,以验证其预警效果。结果重症患者非计划性拔管预警系统雏形由登录模块、评估模块、决策模块、预警模块、指导模块及管道固定方案模块6个主题模块集成,系统自动判断重症患者风险等级,从而实行分级预警,筛选高危风险人群,最终提供个性化护理干预方案。经回顾性分析,该预警系统的检测率为88.89%。结论重症患者非计划性拔管预警系统是一个自动化、智能化、信息化的预警平台,能有效预警拔管高危患者,规避管道护理风险。

Objective To develop early warning systems for unplanned extubation in critical patients to give the early warning and interference in order to reduce the risks of unexpected drawn tubes and guarantee the security of the patients.Methods Took the model of risk warning system for unplanned extubation in critical patients as the core,obeyed the guide of the nursing intervention program,based on the information system of patients in ICU and relied on computer science technology to design the architecture for the interface layout,the partitions,the modular structure,the content and the function of the system.This warning system was designed from multiple angels and directions.This research retrospectively analyzed the 18 cases for unplanned extubation from January to December in 2016 using this system to verify its warning effectiveness.Results The prototype of this warning system included login module,evaluation module,decision module,warning module,directive module and the module for canal fixed scheme.The system automatically determined the level of risk for critical patients to implement the layered pre-warning and screen the high-risk patients.Finally,individual nursing interfering method could be supplied.The detection rate of this warning system was 88.89%after retrospective analysis.Conclusion The warning system for unplanned extubation patients is an automated,intellectualized and informationalized platform.It can effectively warn the high risk of the extubation patients and evade the risk of canal nursing.