利用电子健康记录工具来改善细支气管炎住院儿童的循证治疗
2026年7月16日 更新者：Johns Hopkins University
使用BPA促进支气管炎中的高价值护理：一项随机对照研究
这项实验研究的目的是了解不同类型的最佳实践咨询（BPA）是否指导临床医生参考嵌入电子健康记录中的临床准则（EHR）增加了在患有支气管炎医院的儿童中提供基于证据的护理的验证。 它旨在回答的主要问题是：
- BPA是否可以改善临床医生在支气管炎中提供指南符合护理？
- 干扰性BPA是否比非互发性BPA更能改善细支气管炎的准则协同护理？
研究人员将将其临床医生未接受BPA的患者的治疗和结果与临床医生接受非互发性BPA的患者与临床医生接受过BPA的患者进行比较。
患者将继续接受支气管炎的标准医院护理。
临床医生将：
- 保留访问EHR的EHR临床指南的细支性临床指南
- 暴露于无BPA，无中断的BPA或促进EHR被安装的临床指南的中断性BPA（每位患者相遇）
研究概览
详细说明
支气管炎是一种影响婴儿和幼儿的病毒呼吸道疾病，是儿童不到2岁的最常见原因。 但是，许多接受支气管炎的儿童接受了不必要的治疗，这些治疗不会加速康复，甚至可能造成伤害。 尽管有证据表明，对支气管炎的最佳治疗方法是支持治疗（即 氧气和水合支持），临床医生继续过度使用某些疗法，导致住院时间更长，成本更高，家庭压力增加。
研究人员将研究BPA的影响，BPA是EHR内的实时警报。 这项研究中的BPA促进了嵌入EHR中的细支气管炎的基于证据的护理指南。 EHR中常用的BPA设计多种：1）Intruction BPA，要求临床医生与警报互动以继续临床医生的工作流程； 2）无间断的BPA，它显示为视觉提示，但不需要临床医生改变工作流程。
研究类型
介入性
注册 (实际的)
2965
阶段
- 不适用
联系人和位置
本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。
学习地点
-
-
Florida
-
St. Petersburg、Florida、美国、33701
- Johns Hopkins All Children's Hospital
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-
Maryland
-
Baltimore、Maryland、美国、21224
- Johns Hopkins Bayview Medical Center
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Baltimore、Maryland、美国、21287
- Johns Hopkins Children's Center
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-
参与标准
研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。
资格标准
适合学习的年龄
- 孩子
接受健康志愿者
不
描述
患者纳入标准：
- 儿童<= 24个月大的儿童在三个研究地点之一的急诊室和/或患有细支气管炎的住院（在观察或住院状态下）。
患者排除标准：
- 当前的遭遇是出生
- 目前在ICU住院
- 住院时间> 14天
临床医生的纳入标准：
- 医师和高级执业提供者进入患者图表或急诊科（ED）和住院的订单进入活动
临床医生排除标准：
- 不输入患者图表或订单输入活动的医师和高级执业提供者
学习计划
本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。
研究是如何设计的？
设计细节
- 主要用途：治疗
- 分配：随机化
- 介入模型：并行分配
- 屏蔽：无（打开标签）
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
|
无干预：No EHR-Alert
Clinicians will not be exposed to a any EHR-alert about the care of bronchiolitis.
The participants will still have access to the EHR-embedded, evidence-based clinical guideline.
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|
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实验性的：Interruptive EHR-Alert
Clinicians will be exposed to an interruptive EHR-alert directing the clinician to reference the EHR-embedded, evidence-based clinical guideline for the care of bronchiolitis.
|
The interruptive EHR alert requires clinicians to interact with the alert to continue the workflow.
The alert directs clinicians to reference the EHR-embedded, evidence-based clinical guideline for the care of bronchiolitis.
|
|
实验性的：Non-interruptive EHR-Alert
Clinicians will be exposed to an non-interruptive EHR-Alert directing the clinician to reference the EHR-embedded, evidence-based clinical guideline for the care of bronchiolitis.
|
The non-interruptive EHR alert appears as a visual cue but does not require clinicians to alter workflows.
The alert directs clinicians to reference the EHR-embedded, evidence-based clinical guideline for the care of bronchiolitis.
|
研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Proportion of encounters provider utilizes EHR-integrated clinical decision support tool
大体时间：From enrollment to the end of ED encounter (approximately <24 hours) for non-hospitalized patients; End of hospital stay (approximately 2-4 days) for hospitalized patients
|
Use of the EHR-integrated Clinical Decision Support Guideline.
The proportion of encounters in which a provider utilizes the EHR-integrated clinical decision support tool for the care of bronchiolitis during a given encounter.
|
From enrollment to the end of ED encounter (approximately <24 hours) for non-hospitalized patients; End of hospital stay (approximately 2-4 days) for hospitalized patients
|
次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Proportion of encounters providers utilize the EHR-integrated clinical decision support tool for the care of bronchiolitis
大体时间：From enrollment to the end of ED encounter (approximately <24 hours) for non-hospitalized patients; End of hospital stay (approximately 2-4 days) for hospitalized patients
|
Multiple Use of the EHR-integrated clinical decision support guideline.
The proportion of encounters in which providers utilize the EHR-integrated clinical decision support tool for the care of bronchiolitis multiple times (2 or more times) during a given encounter.
|
From enrollment to the end of ED encounter (approximately <24 hours) for non-hospitalized patients; End of hospital stay (approximately 2-4 days) for hospitalized patients
|
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Proportion of encounters a provider enters orders via the EHR-integrated clinical decision support tool
大体时间：From enrollment to the end of ED encounter (approximately <24 hours) for non-hospitalized patients; End of hospital stay (approximately 2-4 days) for hospitalized patients
|
Order entry via the EHR-integrated clinical decision support guideline.
The proportion of encounters a provider enters orders via the EHR-integrated clinical decision support tool for the care of bronchiolitis during a given encounter.
|
From enrollment to the end of ED encounter (approximately <24 hours) for non-hospitalized patients; End of hospital stay (approximately 2-4 days) for hospitalized patients
|
其他结果措施
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Proportion of patients who receive any subtherapeutic high flow nasal cannula (HFNC) treatment
大体时间：From enrollment to the end of ED encounter (approximately <24 hours) for non-hospitalized patients; End of hospital stay (approximately 2-4 days) for hospitalized patients
|
Post-randomization - Individual Clinical Outcome 1 - Subtherapeutic HFNC.
The proportion of patients who receive any subtherapeutic high flow nasal cannula (HFNC) treatment, defined as HFNC with a flow rate <1L/kg/min for patients <15kg or <15L/min for patients >15kg.
Comparator groups will be those in whom providers utilized the EHR-integrated clinical decision support guideline vs. those in whom the guideline was not accessed.
|
From enrollment to the end of ED encounter (approximately <24 hours) for non-hospitalized patients; End of hospital stay (approximately 2-4 days) for hospitalized patients
|
|
The average number of hours during which a patient received subtherapeutic high flow nasal cannula (HFNC) treatment
大体时间：From enrollment to the end of ED encounter (approximately <24 hours) for non-hospitalized patients; End of hospital stay (approximately 2-4 days) for hospitalized patients
|
Post Randomization - Individual Clinical Outcome 2 - Hours spent on subtherapeutic HFNC.
The average number of hours during which a patient received subtherapeutic high flow nasal cannula (HFNC) treatment, defined as HFNC with a flow rate <1L/kg/min for patients <15kg or <15L/min for patients >15kg.
Comparator groups will be those in whom providers utilized the EHR-integrated clinical decision support guideline vs. those in whom the guideline was not accessed.
|
From enrollment to the end of ED encounter (approximately <24 hours) for non-hospitalized patients; End of hospital stay (approximately 2-4 days) for hospitalized patients
|
|
Proportion of patients who receive any treatment with high flow nasal cannula
大体时间：From enrollment to the end of ED encounter (approximately <24 hours) for non-hospitalized patients; End of hospital stay (approximately 2-4 days) for hospitalized patients
|
Post Randomization - Systems Level Outcome 1 - Proportion Receiving any HFNC.
The proportion of patients who receive any treatment with high flow nasal cannula.
Comparator groups will be those in whom providers utilized the EHR-integrated clinical decision support guideline vs. those in whom the guideline was not accessed.
|
From enrollment to the end of ED encounter (approximately <24 hours) for non-hospitalized patients; End of hospital stay (approximately 2-4 days) for hospitalized patients
|
|
The total time (in hours) during which patients received any treatment with high flow nasal cannula
大体时间：From enrollment to the end of ED encounter (approximately <24 hours) for non-hospitalized patients; End of hospital stay (approximately 2-4 days) for hospitalized patients
|
Post Randomization - Systems Level Outcome 2 - Total time on HFNC.
The total time (in hours) during which patients received any treatment with high flow nasal cannula.
Comparator groups will be those in whom providers utilized the EHR-integrated clinical decision support guideline vs. those in whom the guideline was not accessed.
|
From enrollment to the end of ED encounter (approximately <24 hours) for non-hospitalized patients; End of hospital stay (approximately 2-4 days) for hospitalized patients
|
合作者和调查者
在这里您可以找到参与这项研究的人员和组织。
调查人员
- 首席研究员：Benjamin E Bodnar, MD、Johns Hopkins University
研究记录日期
这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。
研究主要日期
学习开始 (实际的)
2025年5月5日
初级完成 (实际的)
2026年6月12日
研究完成 (实际的)
2026年7月12日
研究注册日期
首次提交
2025年4月10日
首先提交符合 QC 标准的
2025年4月10日
首次发布 (实际的)
2025年4月17日
研究记录更新
最后更新发布 (实际的)
2026年7月17日
上次提交的符合 QC 标准的更新
2026年7月16日
最后验证
2026年7月1日
更多信息
此信息直接从 clinicaltrials.gov 网站检索，没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求，请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改，我们的网站上也会自动更新.