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首页> 外文期刊>JMIR Human Factors >Role of Large Clinical Datasets From Physiologic Monitors in Improving the Safety of Clinical Alarm Systems and Methodological Considerations: A Case From Philips Monitors
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Role of Large Clinical Datasets From Physiologic Monitors in Improving the Safety of Clinical Alarm Systems and Methodological Considerations: A Case From Philips Monitors

机译：来自生理监护仪的大型临床数据集在改善临床警报系统和方法考量的安全性中的作用：以飞利浦监护仪为例

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Background Large datasets of the audit log of modern physiologic monitoring devices have rarely been used for predictive modeling, capturing unsafe practices, or guiding initiatives on alarm systems safety. Objective This paper (1) describes a large clinical dataset using the audit log of the physiologic monitors, (2) discusses benefits and challenges of using the audit log in identifying the most important alarm signals and improving the safety of clinical alarm systems, and (3) provides suggestions for presenting alarm data and improving the audit log of the physiologic monitors. Methods At a 20-bed transplant cardiac intensive care unit, alarm data recorded via the audit log of bedside monitors were retrieved from the server of the central station monitor. Results Benefits of the audit log are many. They include easily retrievable data at no cost, complete alarm records, easy capture of inconsistent and unsafe practices, and easy identification of bedside monitors missed from a unit change of alarm settings adjustments. Challenges in analyzing the audit log are related to the time-consuming processes of data cleaning and analysis, and limited storage and retrieval capabilities of the monitors. Conclusions The audit log is a function of current capabilities of the physiologic monitoring systems, monitor’s configuration, and alarm management practices by clinicians. Despite current challenges in data retrieval and analysis, large digitalized clinical datasets hold great promise in performance, safety, and quality improvement. Vendors, clinicians, researchers, and professional organizations should work closely to identify the most useful format and type of clinical data to expand medical devices’ log capacity.
机译：背景技术现代生理监测设备的审计日志的大型数据集很少用于预测建模，捕获不安全的做法或指导警报系统安全的措施。目的本文（1）使用生理监测器的审核日志描述了一个大型临床数据集，（2）讨论了使用审核日志来识别最重要的警报信号并提高临床警报系统安全性的好处和挑战，以及（ 3）为提出警报数据和改善生理监护仪的审核日志提供建议。方法在一个有20张床的心脏重症监护病房，从床旁监护仪的审计日志中记录的警报数据是从中央监护仪的服务器中检索的。结果审核日志的好处很多。它们包括免费的易于检索的数据，完整的警报记录，容易捕获的不一致和不安全的做法以及容易识别因警报设置调整的单位变更而遗漏的床头监护仪。分析审核日志的挑战与数据清理和分析的耗时过程以及监视器的有限存储和检索功能有关。结论审核日志是生理监护系统当前功能，监护仪配置以及临床医生警报管理实践的功能。尽管目前在数据检索和分析方面存在挑战，但大型数字化临床数据集在性能，安全性和质量改进方面具有广阔的前景。供应商，临床医生，研究人员和专业组织应密切合作，以确定最有用的临床数据格式和类型，以扩大医疗设备的日志容量。

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