An effective computerized reminder for contact isolation of patients colonized or infected with resistant organisms

作者：Kho Abel N^*; Dexter Paul R; Warvel Jeff S; Belsito Anne W; Commiskey Marie; Wilson Stephen J; Hui Siu L; McDonald Clement J

来源：International Journal of Medical Informatics, 2008, 77(3): 194-198.

DOI：10.1016/j.ijmedinf.2007.02.005

• clinical decision support systems
• reminder systems
• infection control
• methicillin-resistance
• Staphylococcus aureus
• vancomycin resistance
• enterococcus

Purpose: To improve contact isolation rates among patients admitted to the hospital with a known history of infection with Methicillin-resistant Staphylococcus aureus (MRSA) and Vancomycin-resistant Enterococci (VRE).
Methods: A before and after interventional study implementing computerized reminders for contact isolation between February 25, 2005 and February 28, 2006. We measured rates of appropriate contact isolation, and time to isolation for the 4 month pre-intervention period, and the 12 month intervention period. We conducted a survey of ordering physicians at the midpoint of the intervention period.
Results: Implementing a computerized reminder increased the rate of patients appropriately isolated from 33% to fully 89% (P<0.0001). The median time to writing contact isolation orders decreased from 16.6 to 0.0h (P<0.0001). Physicians accepted the order 80% of the time on the first or second presentation. Ninety-five percent of physicians felt the reminder had no impact on workflow, or saved them time.
Conclusion: A human reviewed computerized reminder can achieve high rates of compliance with infection control recommendations for contact isolation, and dramatically reduce the time to orders being written upon admission.

• 出版日期2008-3
• 单位西北大学