集成化临床信息系统对重症医学医疗质量控制的应用研究

注册号:

Registration number:

ChiCTR-OOC-16008555 

最近更新日期:

Date of Last Refreshed on:

2016-05-28 20:03:07 

注册时间:

Date of Registration:

2016-05-29 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

集成化临床信息系统对重症医学医疗质量控制的应用研究

Public title:

The impact of integrated clinical information system(ICIS) implementation in the ICU upon the quality of care.

注册题目简写:

English Acronym:

研究课题的正式科学名称:

集成化临床信息系统对重症医学医疗质量控制的应用研究

Scientific title:

The impact of integrated clinical information system(ICIS) implementation in the ICU upon the quality of care.

研究课题代号(代码):

Study subject ID:

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

邱泽亮 

研究负责人:

邱泽亮 

Applicant:

Qiu Zeliang 

Study leader:

Qiu Zeliang 

申请注册联系人电话:

Applicant telephone:

+86 18121216112

研究负责人电话:

Study leader's
telephone:

+86 18121216112

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

zlqiu1121@163.com

研究负责人电子邮件:

Study leader's E-mail:

zlqiu1121@163.com

申请单位网址(自愿提供):

Applicant website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website(voluntary supply):

申请注册联系人通讯地址:

上海市浦东新区周园路1500号

研究负责人通讯地址:

上海市浦东新区周园路1500号

Applicant address:

1500 Zhouyuan Road, Shanghai, Pudong New Area, Shanghai, China

Study leader's address:

1500 Zhouyuan Road, Shanghai, Pudong New Area, Shanghai, China

申请注册联系人邮政编码:

Applicant postcode:

201318

研究负责人邮政编码:

Study leader's postcode:

201318

申请人所在单位:

上海健康医学院附属周浦医院

Applicant's institution:

Zhoupu Hospital Affiliated to Shanghai University of Medicine & Health Sciences

研究负责人所在单位:

上海健康医学院附属周浦医院

Affiliation of the Leader:

Zhoupu Hospital Affiliated to Shanghai University of Medicine & Health Sciences

是否获伦理委员会批准:

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

ZPYYLL-2015-18

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件View

批准本研究的伦理委员会名称:

上海市浦东新区周浦医院医学伦理委员会

Name of the ethic committee:

Scientific Research Approval Determination of Independent Ethics Committee of Shanghai Pudong New Aear Zhoupu Hospital.

伦理委员会批准日期:

Date of approved by ethic committee:

2015-05-27 00:00:00

伦理委员会联系人:

Contact Name of the ethic committee:

伦理委员会联系地址:

Contact Address of the ethic committee:

伦理委员会联系人电话:

Contact phone of the ethic committee:

伦理委员会联系人邮箱:

Contact email of the ethic committee:

研究实施负责(组长)单位:

上海健康医学院附属周浦医院

Primary sponsor:

Zhoupu Hospital Affiliated to Shanghai University of Medicine & Health Sciences

研究实施负责(组长)单位地址:

上海市浦东新区周园路1500号

Primary sponsor's address:

1500 Zhouyuan Road, Shanghai, Pudong New Area, Shanghai, China

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

上海市

市(区县):

Country:

China

Province:

Shanghai

City:

单位(医院):

上海健康医学院附属周浦医院

具体地址:

上海市浦东新区周园路1500号

Institution
hospital:

Zhoupu Hospital Affiliated to Shanghai University of Medicine & Health Sciences

Address:

1500 Zhouyuan Road, Shanghai, Pudong New Area, Shanghai, China

经费或物资来源:

上海健康医学院及其附属周浦医院

Source(s) of funding:

Shanghai University of Medicine & Health Sciences and Zhoupu Hospital

研究疾病:

危重病  

Target disease:

Critically ill patients

研究疾病代码:

Target disease code:

研究类型:

观察性研究

Study type:

Observational study

研究所处阶段:

其它 

Study phase:

N/A

研究设计:

队列研究 

Study design:

Cohort study 

研究目的:

在ICU临床诊疗过程中产生的数据量巨大,医疗数据管理和处理非常耗时。国内外许多医院虽然建立了临床信息系统,但是,关于临床信息系统对医疗质量的影响客观证据依然很少。本项目拟在前期集成化临床信息系统(ICIS)建立基础上进行临床效果评价,以2015版国家卫生计生委颁发的ICU医疗质量控制指标为核心指标,纵向比较应用新系统前后两阶段各核心指标的变化,探讨ICIS对医疗质量的影响,为ICU的信息化建设提供一定的依据,最终达到提高医疗质量的目的。  

Objectives of Study:

Managing and processing medical data can be very time consuming and this is very obvious in intensive care units (ICU) settings where physicians are confronted with a vast amount of information generated by their patients. Although integrated clinical information systems (ICIS) have been available and implemented in many ICU for more than a decade, there is little objective evidence of their impact on the quality of care. we conducted the present study in order to evaluate the impact of ICIS implementation upon the quality of care according to the ICU medical quality indexs issued by the national health and family planning commission in 2015.

药物成份或治疗方案详述:

 

Description for medicine or protocol of treatment in detail:

 

纳入标准:

Inclusion criteria

排除标准:

1)年龄小于18周岁的患者:2)入ICU 24小时内死亡者。

Exclusion criteria:

1. Aged less than 18 years old; 2. died within 24 hours.

研究实施时间:

Study execute time:

From 2016-01-01 00:00:00 To 2018-12-31 00:00:00  

征募观察对象时间:

Recruiting time:

From 2016-06-01 00:00:00 To 2018-05-31 00:00:00

干预措施:

Interventions:

组别:

1)对照组:实施ICIS 前所有收住ICU治疗的患者,2) (1) 实验组:实施ICIS 6个月后所有收住ICU治疗的患者

样本量:

700

Group:

1)Control group:before the implementation of ICIS (BEFORE) and 2) Experimental group: after implementation of ICIS (AFTER)

Sample size:

干预措施:

实施ICIS指导临床

干预措施代码:

Intervention:

Implementation of integrated clinical information system(ICIS)

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

上海市 

市(区县):

 

Country:

China

Province:

Shanghai

City:

单位(医院):

上海健康医学院附属周浦医院 

单位级别:

二级甲等 

Institution
hospital:

Zhoupu Hospital Affiliated to Shanghai University of Medicine & Health Sciences

Level of the institution:

Second A hospital

测量指标:

Outcomes:

指标中文名:

ICU患者标化病死指数

指标类型:

主要指标

Outcome:

Standardized Mortality Ratio

Type:

Primary indicator

测量时间点:

测量方法:

通过患者疾病危重程度校准后的病死率,为ICU患者实际病死率与同期ICU患者预计病死率的比值。ICU实际病死率为ICU死亡患者数(包括因不可逆疾病而自动出院的患者)占同期ICU收治患者总数的比例,除外入院时已脑死亡,因器官捐献而收治ICU的患者。

Measure time point of outcome:

Measure method:

指标中文名:

ICU非计划气管插管拔管率

指标类型:

次要指标

Outcome:

The rate of unplanned decannulation (UD) in Intensive Care Unit

Type:

Secondary indicator

测量时间点:

测量方法:

非计划气管插管拔管例数占同期ICU患者气管插管拔管总数的比例。

Measure time point of outcome:

Measure method:

指标中文名:

ICU呼吸机相关性肺炎(VAP)发病率

指标类型:

次要指标

Outcome:

The incidence of ventilator associated pneumonia (VAP) in Intensive Care Unit

Type:

Secondary indicator

测量时间点:

测量方法:

VAP发生例数占同期ICU患者有创机械通气总天数的比例。单位:例/千机械通气日。

Measure time point of outcome:

Measure method:

指标中文名:

ICU血管内导管相关血流感染(CRBSI)发病率

指标类型:

次要指标

Outcome:

The incidence of intravascular catheter-related bloodstream infection (CRBSI) in Intensive Care Unit

Type:

Secondary indicator

测量时间点:

测量方法:

CRBSI发生例数占同期ICU患者血管内导管留置总天数的比例。单位:例/千导管日。

Measure time point of outcome:

Measure method:

指标中文名:

ICU导尿管相关泌尿系感染(CAUTI)发病率

指标类型:

次要指标

Outcome:

The incidence of catheter associated urinary tract infection (CAUTI) in Intensive Care Unit

Type:

Secondary indicator

测量时间点:

测量方法:

CAUTI发生例数占同期ICU患者导尿管留置总天数的比例。单位:例/千导尿管日。

Measure time point of outcome:

Measure method:

指标中文名:

感染性休克3h集束化治疗(bundle)完成率

指标类型:

次要指标

Outcome:

The rate of compliance with 3-hour sepsis bundles in patients with Septic shock

Type:

Secondary indicator

测量时间点:

测量方法:

感染性休克3h集束化治疗(bundle),是指感染性休克诊断后3小时内完成:测量乳酸浓度;抗菌药物治疗前进行血培养;予以广谱抗菌药物;低血压或乳酸≥4mmol/L给予30ml/kg晶体液进行目标复苏。感染性休克3h集束化治疗(bundle)完成率,是指入ICU诊断为感染性休克并全部完成3h bundle的患者数占同期入ICU诊断为感染性休克患者总数的比例。不包括住ICU期间后续新发生的感染性休克病例。

Measure time point of outcome:

Measure method:

指标中文名:

感染性休克 6h集束化治疗(bundle)完成率

指标类型:

次要指标

Outcome:

The rate of compliance with 6-hour sepsis bundles in patients with Septic shock

Type:

Secondary indicator

测量时间点:

测量方法:

指在3h集束化治疗(bundle)的基础上加上:低血压对目标复苏效果差立即予以升压药;脓毒症休克或乳酸≥4mmol/L容量复苏后仍持续低血压,需立即测量CVP 和 ScvO2;初始乳酸高于正常患者需重复测量乳酸水平。感染性休克6h集束化治疗(bundle)完成率,是指入ICU诊断为感染性休克全部完成6h bundle的患者数占同期入ICU诊断为感染性休克患者总数的比例。不包括住ICU期间后续新发生的感染性休克病例。

Measure time point of outcome:

Measure method:

采集人体标本:

Collecting sample(s)
from participants:

征募研究对象情况:

Recruiting status:

正在进行

Recruiting

年龄范围:

Participant age:

最小 Min age 18 years
最大 Max age 100 years

性别:

男女均可

Gender:

Both

随机方法(请说明由何人用什么方法产生随机序列):

本研究类型为前后对照的纵向观察性研究,因此未涉及到随机方法。

Randomization Procedure (please state who generates the random number sequence and by what method):

The current investigation will not involve randomization procedure.

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

公开/Public

盲法:

Blinding:

试验完成后的统计结果(上传文件):

Calculated Results after
the Study Completed(upload file):

是否共享原始数据:

IPD sharing

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

将在2018年以论文形式公开

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

It will be published in the form of papers in 2018.

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

上海健康医学院附属周浦医院

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

Zhoupu Hospital Affiliated to Shanghai University of Medicine & Health Sciences

数据与安全监察委员会:

Data and Safety Monitoring Committee:

注册人:

Name of Registration:

 2016-05-28 20:03:07