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首页> 外文期刊>Canadian Journal of Emergency Medicine >Photodocumentation as an emergency department documentation tool in soft tissue infection: a randomized trial
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Photodocumentation as an emergency department documentation tool in soft tissue infection: a randomized trial

机译：作为软组织感染急诊科记录工具的照片记录：一项随机试验

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Objectives: Current documentation methods for patientswith skin and soft tissue infections receiving outpatientparenteral anti-infective therapy (OPAT) include writtendescriptions and drawings of the infection that may inadequately communicate clinical status. We undertook a studyto determine whether photodocumentation (PD) improvesthe duration of outpatient treatment of skin and soft tissueinfections.Methods: A single-blinded, prospective, randomized trialwas conducted in the emergency departments of a community hospital and an academic tertiary centre. Participantsincluded consecutive patients age $ 14 years presenting withnoninvasive skin and soft tissue infections requiring OPAT.Patients in the intervention arm were treated with standardof care plus PD at each emergency physician assessment.Control subjects received care provided at the discretion ofthe treating physician and non-photographic documentation.The primary outcome was duration of therapy measuredin half-days. The required sample size to detect a differenceof one half-day was 253 patients per group (a 5 0.05).Secondary outcomes included (1) completion and therapeutic failure rates, (2) patient satisfaction, and (3) physicianand nurse satisfaction.Results: Enrolment was slower and follow-up rates lowerthan anticipated, and the trial was terminated when fundswere exhausted. A total of 468 subjects with similar age andgender characteristics were enrolled, with 244 receiving theintervention and 224 in the control arm. The mean OPATduration was similar in the two groups (3.6 days v. 3.5 days,p 5 0.73). No differences in the rate for completion andtherapeutic failure were observed (71% v. 68% and , 1% forboth, respectively). Survey response rates varied significantly: patients, 65%; nurses, 17%; and physicians, 87%.Physicians endorsed more comfort with their assessmentand OPAT judgment with PD (65% and 64%, respectively).
机译：目标：目前接受门诊肠胃外抗感染治疗（OPAT）的皮肤和软组织感染患者的文献记录方法包括感染的书面描述和附图，可能无法充分传达临床状况。我们进行了一项研究，以确定照片记录（PD）是否可以改善皮肤和软组织感染的门诊治疗时间。方法：在社区医院和学术第三级急诊室进行了单盲，前瞻性，随机试验。参与者包括年龄在14岁以下且需要进行OPAT的无创性皮肤和软组织感染的连续患者。在每次紧急医师评估中，干预组的患者均接受标准护理加上PD的治疗。对照组由治疗医师酌情提供护理，且非照相主要结果是半天的治疗时间。每半天差异所需的样本量为每组253名患者（a 5 0.05）。次要结果包括（1）完成率和治疗失败率，（2）患者满意度以及（3）医生和护士满意度。 ：入选速度较慢，随访率低于预期，并且在资金用尽时终止了试验。共有468名年龄和性别特征相似的受试者入组，其中244名接受了干预，而224名接受了控制。两组的平均OPAT持续时间相似（3.6天对3.5天，p 5 0.73）。没有观察到完成和治疗失败率的差异（分别为71％对68％和，两者均为1％）。调查的回复率差异很大：患者为65％;护士，占17％;医师为87％。医师对PD的评估和OPAT判断更为满意（分别为65％和64％）。

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