期刊文章%@ 2292-9495 %I JMIR出版物% v8 %N 卡塔尔世界杯8强波胆分析1 %P e25724 %T COVID-19重症监护协作结构:回顾性网络分析研究%A Yan,Chao %A Zhang,Xinmeng %A Gao,Cheng %A Wilfong,Erin %A Casey,Jonathan %A France,Daniel %A Gong,Yang %A Patel,Mayur %A Malin,Bradley %A Chen,You %+范德比尔特大学医学中心生物医学信息系，田纳西州纳什维尔West End Ave 2525号，37203，美国，1 615 343 1939，you.chen@vanderbilt.edu %K COVID-19 %K重症监护室%K协作结构%K危重病人%K卫生保健工作者%K网络分析%K电子健康记录%K协作%K危重护理%K关系%K安全%K团队合作%D jjmir Hum Factors %G English %X背景:很少有重症监护病房(ICU)人员配置研究考察了卫生保健工作者(HCWs)的协作结构。了解医护人员如何与COVID-19重症患者的护理联系起来，对于描述团队结构、护理质量和患者安全之间的关系非常重要。目的:通过比较HCW在合并和未合并COVID-19的危重症患者管理中的协作，发现重症监护团队结构的差异。方法:采用回顾性研究方法，采用网络分析方法对76例危重患者(新冠肺炎:38例;没有COVID-19: n=38)，他们被一家大型学术医疗中心录取，并了解HCW合作。我们使用了2020年3月17日至2020年5月31日期间在范德比尔特大学医学中心(美国田纳西州纳什维尔)入住COVID-19 ICU的成年患者的电子病历。我们根据每个病人的年龄、性别和住院时间进行了匹配。2019年12月1日至2020年2月29日期间，非COVID-19患者入住内科ICU。 We used two sociometrics—eigencentrality and betweenness—to quantify HCWs’ statuses in networks. Eigencentrality characterizes the degree to which an HCW is a core person in collaboration structures. Betweenness centrality refers to whether an HCW lies on the path of other HCWs who are not directly connected. This sociometric was used to characterize HCWs’ broad skill sets. We measured patient staffing intensity in terms of the number of HCWs who interacted with patients’ EHRs. We assessed the statistical differences in the core and betweenness statuses of HCWs and the patient staffing intensities of COVID-19 and non–COVID-19 critical care, by using Mann-Whitney U tests and reporting 95% CIs. Results: HCWs in COVID-19 critical care were more likely to frequently work with each other (eigencentrality: median 0.096) than those in non–COVID-19 critical care (eigencentrality: median 0.057; P<.001). Internal medicine physicians in COVID-19 critical care had higher core statuses than those in non–COVID-19 critical care (P=.001). Nurse practitioners in COVID-19 care had higher betweenness statuses than those in non–COVID-19 care (P<.001). Compared to HCWs in non–COVID-19 settings, the EHRs of critically ill patients with COVID-19 were used by a larger number of internal medicine nurse practitioners (P<.001), cardiovascular nurses (P<.001), and surgical ICU nurses (P=.002) and a smaller number of resident physicians (P<.001). Conclusions: Network analysis methodologies and data on EHR use provide a novel method for learning about differences in collaboration structures between COVID-19 and non–COVID-19 critical care. Health care organizations can use this information to learn about the novel changes that the COVID-19 pandemic has imposed on collaboration structures in urgent care. %M 33621187 %R 10.2196/25724 %U https://humanfactors.www.mybigtv.com/2021/1/e25724 %U https://doi.org/10.2196/25724 %U http://www.ncbi.nlm.nih.gov/pubmed/33621187