Implementation of clinical guidelines using a computer charting system : Effect on the initial care of health care workers exposed to body fluids.
Context. - While clinical guidelines are considered an important mechanism to improve the quality of medical care, problems with implementation may limit their effectiveness.
Few empirical data exist about the effect of computer-based systems for application of clinical guidelines on quality of care.
- To determine whether real-time presentation of clinical guidelines using an electronic medical record can increase compliance with guidelines.
- Prospective off-on-off, interrupted time series with intent-to-treat analysis.
- University hospital emergency department.
- Patients were 280 health care workers (50 in the baseline control phase, 156 in the intervention phase, and 74 in the postintervention control phase) who presented for initial treatment of occupational body fluid exposures, including 89% (248/280) who sustained punctures and 81% (208/257) who were exposed to blood.
Physicians included resident physicians and attending physicians working in the emergency department during the study.
- Implementation of a computer charting system that provides real-time information regarding history and recommendations for laboratory testing, treatment, and disposition based on rules derived from clinical guidelines.
Main Outcome Measures
Mots-clés Pascal : Guide pratique, Assistance ordinateur, Exposition professionnelle, Liquide corporel, Dossier médical, Agent santé, Traitement, Essai laboratoire, Homme
Mots-clés Pascal anglais : Handbook, Computer aid, Occupational exposure, Body fluid, Medical record, Health worker, Treatment, Laboratory test, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0032599
Code Inist : 002B30B01B. Création : 17/04/1998.