Journal of clinical monitoring and computing
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J Clin Monit Comput · Feb 1998
Comparative StudyDevelopment and assessment of a computer-based preanesthetic patient evaluation system for obstetrical anesthesia.
Computerization of the medical record in various outpatient settings has been successful but for anesthesiologists, the preoperative visit differs significantly. This study implemented a computerized version of a structured preanesthetic evaluation questionnaire that we had previously developed and which provided a starting point for developing a suitable vocabulary and workflow. ⋯ The introduction of a computer into the physician-patient relationship did not disrupt the examination. It markedly reduced time-consuming tasks (such as dictation), captured far more detail than found in our previously dictated and handwritten notes and provided immediately available data for quality assurance activities.
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J Clin Monit Comput · Feb 1998
The Diatek Arkive "Organizer" patient information management system: experience at a university hospital.
To install and successfully use early commercial automatic anesthesia recordkeepers, the Diatek Arkive "Organizer" units, in the operating rooms at a major university medical center. ⋯ Total resistance to the new devices on the part of a few vocal faculty members was a major factor in the ultimate downfall of the system. The method of introduction, and especially the lack of involvement of faculty, residents, surgeons, operating room personnel, hospital computer personnel, and the hospital administration in the installation also played a role in the failure of the system. Lack of a workable training mechanism for new residents prevented that user group from rapidly gaining comfort with the systems.
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J Clin Monit Comput · Feb 1998
Three years experience with a patient data management system at a neonatal intensive care unit.
We report about our experience with the patient data management system (PDMS) Hewlett Packard CareVue 9000 at two neonatal ICUs. We describe our PDMS configuration (hard- and software), local adjustments and enhancements such as knowledge based systems for calculating the parenteral nutrition of newborn infants (VIE-PNN), for advising medication (VIE-Nmed), and for managing mechanical ventilation (VIE-VENT), and the results of a structured interview with our staff members about the acceptance of the system. Despite some criticism nearly all collaborators liked the system, especially because of its time saving automated documentation of vital data and mechanical ventilation parameters. ⋯ Main points of critique were the system's therapy planning facilities (medication administration records), the restrictive facilities for documenting patient care and the yet unsolved problems of data evaluation and export. PDM systems have to be constantly adapted to the user's needs and to the changing clinical environment. Living with the system asks for an intensive dialog with the system and its functionalities, for creativity and well defined ideas about the future system development.
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J Clin Monit Comput · Feb 1998
Comparative StudyComparison of blood pressure measured by oscillometry from the supraorbital artery and invasively from the radial artery.
In previous studies, oscillometric blood pressure measured from the supraorbital artery has been shown to agree quite well with pressure measured from the brachial artery in normal subjects. In this study, surgical patients whose conditions warranted the use of invasive blood pressure monitoring during the surgery were chosen. We compared systolic and diastolic blood pressure measured oscillometrically from the supraorbital artery with intraarterial blood pressures, measured invasively from the radial artery. ⋯ For the systolic pressure, the difference between the two methods was -9.9 +/- 17.9 mm Hg (mean +/- SD). For diastolic pressure, the difference was -8.0 +/- 10.9 mm Hg. There was a significant difference between the two methods in the patient population chosen in this study.