基于医院信息化背景的住院患者非计划拔管自动监测系统的研发

Development of Unplanned Extubation Monitoring System for hospitalized patients based on hospital informatization environment

目的:为实时准确、客观便捷地监测非计划拔管事件,基于医院信息系统数据,研发自动提取信息的住院患者非计划拔管自动监测系统,以实现对置管患者的科学管理。方法:通过临床医护流程确定非计划拔管相关数据来源及筛查策略,利用不良事件上报信息修正筛查策略,通过临床调研病例优化筛查策略,并确定疑似病例筛查策略,疑似病例经临床确认后纳入非计划拔管病例数据库。调研2021年1月26日至28日1462例住院患者实际发生非计划拔管情况,同期对比监测系统结果与不良事件上报系统结果,验证监测系统性能。结果:构建的监测系统对调研患者的非计划拔管事件总检出率为50%,高于同时段不良事件上报率0(P=0.016);住院患者非计划拔管自动监测系统实现了非计划拔管的自动监测,并能够分层级、分病区、分时段分析统计。结论:住院患者非计划拔管自动监测系统通过应用医院信息化数据实现了对非计划拔管事件的自动实时、灵敏客观地监测,有助于优化护理工作程序。

Objective:In order to monitor the unplanned extubation events in real time,accurately,objectively and conveniently,and further improve the nursing procedures,an unplanned extubation monitoring system with automatic extraction was developed based on the data of hospital information system,so as to realize the scientific management of patients with catheterization.Methods:Data sources and algorithms related to unplanned extubation were determined through clinical medical and nursing procedures,being corrected by adverse events information,and being further optimized through clinical investigation cases.The suspected cases in the database of unplanned extubation cases were determined after clinical confirmation.Totally 1462 inpatients were included from January 26 to 28,2021,and the results of the monitoring system were compared with those of the adverse event reporting system to verify the performance of the monitoring system.Results:For the monitoring system,the detection rate of unplanned extubation events was 50%,which was higher than that of adverse events reports in the same period(P=0.016).The realization of automatic monitoring of UEX makes the statistics can be analyzed by different levels,different wards and different periods.Conclusion:The unplanned extubation monitoring system based on the analysis of hospital information data can realize sensitive and objective monitoring of unplanned extubation events automaticly and timely,which is helpful to optimize the nursing process.