Nursing process decision support system for urology ward

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• 作者：Angelica Te-Hui Hao^a ; ^f ; Lee-Pin Wu^b ; ^f ; ¹ ; Ajit Kumar^c ; Wen-Shan Jian^d ; Li-Fang Huang^c ; Ching-Chiu Kao^b ; Chien-Yeh Hsu^c ; ^e ; ^{cyhsu@tmu.edu.tw}
• 关键词：Nursing process ; Decision support system ; Clinical pathway ; Urology ; Taiwan
• 刊名：International Journal of Medical Informatics
• 出版年：2013
• 出版时间：July, 2013
• 年：2013
• 卷：82
• 期：7
• 页码：604-612
• 全文大小：728 K

文摘

Purpose

We developed a nursing process decision support system (NPDSS) based on three clinical pathways, including benign prostatic hypertrophy, inguinal hernia, and urinary tract stone. NPDSS included six major nursing diagnoses - acute pain, impaired urinary elimination, impaired skin integrity, anxiety, infection risk, and risk of falling. This paper aims to describe the design, development and validation process of the NPDSS.

Methods

We deployed the Delphi method to reach consensus for decision support rules of NPDSS. A team of nine-member expert nurses from a medical center in Taiwan was involved in Delphi method. The Cronbach's ¦Á method was used for examining the reliability of the questionnaire used in the Delphi method. The Visual Basic 6.0 as front-end and Microsoft Access 2003 as back-end was used to develop the system. A team of six nursing experts was asked to evaluate the usability of the developed systems. A 5-point Likert scale questionnaire was used for the evaluation. The sensitivity and specificity of NPDSS were validated using 150 nursing chart.

Results

The study showed a consistency between the diagnoses of the developed system (NPDSS) and the nursing charts. The sensitivities of the nursing diagnoses including acute pain, impaired urinary elimination, risk of infection, and risk of falling were 96.9 % , 98.1 % , 94.9 % , and 89.9 % respectively; and the specificities were 88 % , 49.5 % , 62 % , and 88 % respectively. We did not calculate the sensitivity and specificity of impaired skin integrity and anxiety due to non-availability of enough sample size.

Conclusions

NPDSS can help nurses in decision making of nursing diagnoses. Besides, it can help them to generate nursing diagnoses based on patient-specific data, individualized care plans, and implementation within their usual nursing workflow.