EVALUATION OF COMPUTER GENERATED NEONATAL DISCHARGE SUMMARIES

被引：31

作者：

LISSAUER, T ^{[1
]}

PATERSON, CM ^{[1
]}

SIMONS, A ^{[1
]}

BEARD, RW ^{[1
]}

机构：

[1] ST MARYS HOSP, SCH MED, DEPT OBSTET, LONDON, ENGLAND

来源：

ARCHIVES OF DISEASE IN CHILDHOOD-FETAL AND NEONATAL EDITION | 1991年 / 66卷 / 04期

关键词：

D O I：

10.1136/adc.66.4_Spec_No.433

中图分类号：

R72 [儿科学];

学科分类号：

100202 ;

摘要：

Computer generated and dictated discharge summaries were compared for all 133 babies admitted for intensive and special care during a six month period. Whereas 130/133 (98%) had a computer generated summary, only 94/133 (71%) had a dictated summary. In addition, computerised summaries were completed at discharge, but there was a delay up to 26 weeks for dictated summaries. Dictated summaries had more items of basic data missing but were more readable. A main diagnosis was missing in only 5/95 (5%) of dictated and 1/130 (1%) computerised summaries. Of the computer generated summaries, 114/133 (86%) were suitable to give to parents. Satisfactory discharge summaries for babies requiring intensive or special care can be generated with an on line computer system.

引用

页码：433 / 436

页数：4

共 2 条

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