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首页> 外文会议>Human Factors and Ergonomics Society annual meeting;HFES 2009 >Computerized Medication Alerts and Prescriber Mental Models: Observing Routine Patient Care
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Computerized Medication Alerts and Prescriber Mental Models: Observing Routine Patient Care

机译：电脑化的药物警戒和处方者心理模型：观察常规患者护理

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摘要

Computerized medication alerts (e.g., drug-drug interactions, drug-allergy interactions), which are intended to protect patient safety, need to match the mental models of medication prescribers in order to aid medication ordering. To maximally protect patient safety, the programmer mental model, system image, and prescriber mental model should work seamlessly together to fully support prescriber decision-making. In this study, we examined prescribing processes in the context of routine patient care to understand how the design of medication alerts can be enhanced for prescribers. We shadowed prescribers, including physicians, pharmacists, and nurse practitioners, across five outpatient primary care clinics at a large Veterans Affairs Medical Center (VAMC). In addition, prescribers were opportunistically interviewed as they ordered mediations via a computerized order entry system and resolved any subsequent medication alerts. This investigation is one of the few to examine medication alerts by directly observing prescribers during patient care. Altogether, 191 medication alerts occurred across 63.5 total hrs of observation, 19 prescribers, and 86 patients during routine patient care tasks. Results reveal problematic system images and mismatches between programmer and prescriber mental models. Findings can help inform medication alert redesigns, which may promote safer, more effective prescribing practices.
机译：旨在保护患者安全的计算机化药物警报（例如，药物相互作用，药物过敏相互作用）需要与药物处方者的心理模型相匹配，以帮助进行药物订购。为了最大程度地保护患者安全，程序员的心理模型，系统映像和处方者的心理模型应无缝协作以完全支持处方者的决策。在这项研究中，我们在常规患者护理的背景下检查了处方过程，以了解如何为处方者增强药物警戒的设计。在大型退伍军人事务医疗中心（VAMC）的五个门诊初级保健诊所中，我们给开处方者（包括医师，药剂师和护士从业者）蒙上了阴影。此外，在开处方者通过计算机化的订单录入系统下达调解命令并解决任何后续用药警报时，他们接受了机会性面试。这项研究是为数不多的在患者护理过程中通过直接观察处方者来检查用药警报的方法之一。在常规的患者护理任务中，总共63.5个小时的观察共发生191次用药警报，有19位处方者和86位患者。结果显示有问题的系统映像以及程序员和处方者心理模型之间的不匹配。这些发现可以帮助告知药物警戒的重新设计，从而可以促进更安全，更有效的处方实践。

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