The N-CODES project: the first year

Clinical decision making is a complex task, and particularly challenging for the novice nurse. Little assistance is available, and decision supports such as standardized guidelines are difficult to access in the hectic flow of practice. The Nursing Computer Decision Support (N-CODES) project, directed by investigators for nursing and computer engineering, addresses this problem by developing a prototype of a point-of-care system to deliver clinical knowledge via a handheld computer. This article reports on the progress made during the first year of the project. The nursing investigators have developed a novice-nurse decision-making model, a comprehensive knowledge development process, and a series of computerized practice maps. The focus of engineering has been on designing the database architecture and the knowledge representation, extraction, and discovery algorithms used to mimic nursing knowledge and clinical decision processes in software. But the success of an interdisciplinary collaborative project depends on establishing tasks and boundaries, clarifying perspectives and language, and developing a productive process. Therefore, along with the progress of each discipline, strategies used to promote collaboration are discussed.