期刊
HEALTHCARE
卷 10, 期 1, 页码 -出版社
MDPI
DOI: 10.3390/healthcare10010035
关键词
critical care patient management; intensive care unit operations; medication delay; patient health measurement; quality of health care; empirical analysis; instrumental variables
This study estimated the harm caused by medication delivery delays in an intensive care unit. The delays around nurse shift changes were found to increase the risks of developing fever, tachypnea, and hypertension.
We estimated the harm related to medication delivery delays across 12,474 medication administration instances in an intensive care unit using retrospective data in a large urban academic medical center between 2012 and 2015. We leveraged an instrumental variables (IV) approach that addresses unobserved confounds in this setting. We focused on nurse shift changes as disruptors of timely medication (vasodilators, antipyretics, and bronchodilators) delivery to estimate the impact of delay. The average delay around a nurse shift change was 60.8 min (p < 0.001) for antipyretics, 39.5 min (p < 0.001) for bronchodilators, and 57.1 min (p < 0.001) for vasodilators. This delay can increase the odds of developing a fever by 32.94%, tachypnea by 79.5%, and hypertension by 134%, respectively. Compared to estimates generated by a naive regression approach, our IV estimates tend to be higher, suggesting the existence of a bias from providers prioritizing more critical patients.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据