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Developing a Decision Support System for Patients with Severe Infection conditions in Prehospital Care.
Int J Infect Dis. 2018 May 10;:
Authors: Johansson N, Spindler C, Valik J, Vicente V
Abstract
OBJECTIVE: To develop and validate a prehospital decision support system (DSS) for the emergency medical services (EMS), enabling identification and steering of patients with critical infectious conditions - severe respiratory tract infections, severe CNS-infections and sepsis - to a specialized emergency department (ED) for infectious diseases.
METHODS: The development process has involved four consecutive steps. The first step was gathering data from the electronic Patient Care Record on patients transported by the EMS, to identify retrospectively appropriate patient categories for steering. The second step was to let a group of medical experts give advice and suggestions for further development of the DSS. The third and fourth steps were evaluation and validation respectively of the whole prehospital DSS in a pilot study.
RESULTS: A prehospital decision support tool (DST) was developed for three medical conditions: severe respiratory infection, severe CNS infection and sepsis. The pilot study included 72 patients, of whom 60% were triaged to a highly Specialized Emergency Department (ED Spec) with an attending infectious disease physician (ID physician) at the ED Spec. The results demonstrated that the prehospital emergency nurses (PENs) adhered to the DST in 66/72 patients (91.6%). Among those patients steered to the ED Spec, the assessment made by PENs and the ID physician at the ED was concordant in 94% of the cases.
CONCLUSION: The development of a specific DSS aiming to identify patients with three different severe infectious diseases seems to give accurate decision support to PENs when steering patients to the optimal level of care.
PMID: 29753877 [PubMed - as supplied by publisher]
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