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Usability Testing of PROCEnf-USP: A Clinical Decision Support System.
Heloisa Helena Ciqueto Peres1, Diná de Almeida Lopes Monteiro da Cruz1, Michelle Tellez2
1School of Nursing, University of Sao Paulo, Brazil.
Studies in Health Technology and Informatics
|August 12, 2015
Summary
Registered nurses (RNs) and decision support systems (DSSs) interact to aid clinical decisions. RNs' education, experience, and judgment mediate DSS effectiveness in nursing diagnosis, highlighting the importance of clinical expertise.
Area of Science:
- Nursing Informatics
- Clinical Decision Support Systems
- Health Information Technology
Background:
- Decision Support Systems (DSSs) are crucial for managing extensive data and enhancing healthcare productivity.
- The effectiveness of DSSs is significantly influenced by their usability and the interaction patterns with healthcare professionals.
- Understanding the interplay between registered nurses (RNs) and DSSs is vital for optimizing clinical decision-making processes.
Purpose of the Study:
- To explore the impact of registered nurse (RN) and Decision Support System (DSS) interactions on RN decision-making.
- To analyze the agreement between RNs and a specific DSS embedded in a nurse documentation system based on NANDA-I.
- To identify factors influencing the agreement between RNs and DSSs in the context of nursing diagnosis selection.
Main Methods:
- Analysis of 24 months of data (2011-2012) from two units in a large public hospital in São Paulo, Brazil.
- Utilized a nurse documentation system with an embedded DSS utilizing NANDA-I terminology.
- Employed mixed effects logistic regression to analyze the agreement between RNs and the DSS in selecting nursing diagnoses.
Main Results:
- Agreement between RNs and the DSS in selecting nursing diagnoses was influenced by RN characteristics (education, experience) and contextual factors (unit, year).
- A surprising finding indicated that disagreement in selecting defining characteristics (DC) positively affected the odds of agreement on nursing diagnoses.
- The study highlights that while DSSs support clinical decision-making, the RN's clinical judgment acts as a crucial mediating factor.
Conclusions:
- Decision Support Systems (DSSs) offer valuable support for nurses' clinical decision-making processes.
- The effectiveness of DSSs is moderated by the registered nurse's (RN) clinical judgment and experience.
- Further research is warranted to fully understand the complex interactions between healthcare professionals and DSSs in clinical practice.
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