Developing a decision support system for patients with severe infection conditions in pre-hospital care
| Autor: | Carl Spindler, Veronica Vicente, John Karlsson Valik, Niclas Johansson |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Microbiology (medical)
Male medicine.medical_specialty Decision support system Emergency Medical Services Pilot Projects lcsh:Infectious and parasitic diseases Sepsis 03 medical and health sciences 0302 clinical medicine medicine Emergency medical services Electronic Health Records Humans lcsh:RC109-216 030212 general & internal medicine Program Development Aged Retrospective Studies Aged 80 and over Respiratory tract infections business.industry Respiratory infection 030208 emergency & critical care medicine General Medicine Emergency department Middle Aged medicine.disease Decision Support Systems Clinical Triage Infectious Diseases Infectious disease (medical specialty) Emergency medicine Female business |
| Zdroj: | International Journal of Infectious Diseases, Vol 72, Iss, Pp 40-48 (2018) |
| ISSN: | 1878-3511 |
| Popis: | Objective: To develop and validate a pre-hospital decision support system (DSS) for the emergency medical services (EMS), enabling the identification and steering of patients with critical infectious conditions (i.e., severe respiratory tract infections, severe central nervous system (CNS) infections, and sepsis) to a specialized emergency department (ED) for infectious diseases. Methods: The development process involved four consecutive steps. The first step was gathering data from the electronic patient care record system (ePCR) on patients transported by the EMS, in order to identify retrospectively appropriate patient categories for steering. The second step was to let a group of medical experts give advice and suggestions for further development of the DSS. The third and fourth steps were the evaluation and validation, respectively, of the whole pre-hospital DSS in a pilot study. Results: A pre-hospital decision support tool (DST) was developed for three medical conditions: severe respiratory infection, severe CNS infection, and sepsis. The pilot study included 72 patients, of whom 60% were triaged to a highly specialized emergency department (ED-Spec) with an attending infectious disease physician (ID physician). The results demonstrated that the pre-hospital emergency nurses (PENs) adhered to the DST in 66 of 72 patient cases (91.6%). For those patients steered to the ED-Spec, the assessment made by PENs and the ID physician at the ED was concordant in 94% of cases. Conclusions: The development of a specific DSS aiming to identify patients with three different severe infectious diseases appears to give accurate decision support to PENs when steering patients to the optimal level of care. Keywords: Emergency medical services, Triage, Nurses, Pneumonia, Sepsis, Central nervous system |
| Databáze: | OpenAIRE |
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