防治医院获得性静脉血栓栓塞症信息化系统的建立与实践

Establishment and practice of information system for prevention and treatment of hospital-acquired venous thromboembolism

目的构建防治医院获得性静脉血栓栓塞症(hospital-acquired venous thromboembolism,HA-VTE)信息化系统并探讨其在静脉血栓栓塞症管理中的应用效果。方法成立HA-VTE管理团队,建立防治HA-VTE信息化系统,主要包括评估、预警、决策、监控4个内容模块,实现时间节点风险评估、评估预警、预防禁忌评估、辅助决策支持、评分监管等功能,达到全院联动防控。2022年10月正式临床应用该系统,比较该系统使用前(2022年4月—9月)、使用后(2022年10月—2023年3月)医院HA-VTE风险评估率、中高危患者预防率、中高危患者预防HA-VTE知识知晓率、中高危患者基础预防措施落实率及HA-VTE发生率等指标。结果防治HA-VTE信息化系统应用后,HA-VTE风险评估率从96.96%上升至100%;中高危患者预防率从37.93%上升至46.86%(其中药物预防率从26.99%上升至37.12%、联合预防率从2.16%上升至4.66%);中高危患者预防HA-VTE知识知晓率从87.76%上升至96.84%,基础预防措施落实率从83.67%上升至94.74%,差异均具有统计学意义(P<0.05);HA-VTE发生率从0.066%下降至0.046%,差异无统计学意义(P>0.05)。结论防治HA-VTE信息化系统能提升护理人员风险评估的依从性,为医护人员提供准确有效的决策依据,改善住院患者HA-VTE管理现状。

Objective To explore the application effect of the information system for prevention and treatment of hospital-acquired venous thromboembolism(HA-VTE)in HA-VTE management.Methods A team of HA-VTE management was set up and the information system for prevention and treatment of HA-VTE was established,which mainly included 4 content modules,namely assessment,early warning,decision-making,and monitoring,in order to achieve functions such as time points risk assessment,early warning assessment,prevention taboo assessment,auxiliary decision support,scoring supervision,and achieve coordinated prevention and control throughout the hospital.The system was officially clinically applied in October 2022.The hospital HA-VTE risk assessment rate,prevention rate among medium to high-risk patients,awareness rate of HA-VTE prevention knowledge among medium to high-risk patients,implementation rate of basic prevention measures among medium to high-risk patients,and incidence rate of HA-VTE were compared before(from April to September 2022)and after(from October 2022 to March 2023)the use of the system.Results After the application of the information system for prevention and treatment of HA-VTE,the risk assessment rate of HA-VTE has increased from 96.96%to 100%.The prevention rate of medium to high-risk patients increased from 37.93%to 46.86%(including the increase of drug prevention rate from 26.99%to 37.12%,and the increase of combined prevention rate from 2.16%to 4.66%).The awareness rate of HA-VTE prevention knowledge for medium to high-risk patients has increased from 87.76%to 96.84%,and the implementation rate of basic preventive measures has increased from 83.67%to 94.74%,with statistically significant differences(P<0.05).The incidence of HA-VTE has decreased from 0.066%to 0.046%.The difference was not statistically significant(P>0.05).Conclusion The information system for prevention and treatment of HA-VTE can enhance the compliance of nursing staff in risk assessment,provide accurate and effective decision-making basis for medical staff,and improve the current situation of HA-VTE management in hospitalized patients.