Studies in health technology and informatics
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Stud Health Technol Inform · Jan 2013
Case-based reasoning in Intelligent Health Decision Support Systems.
Decision-making is a crucial task for decision makers in healthcare, especially because decisions have to be made quickly, accurately and under uncertainty. Taking into account the importance of providing quality decisions, offering assistance in this complex process has been one of the main challenges of Artificial Intelligence throughout history. ⋯ This paper deals with Intelligent Decision Support Systems that are integrated into Electronic Health Records Systems (EHRS) or Public Health Information Systems (PHIS). It provides comprehensive support for a wide range of decisions with the purpose of improving quality of care delivered to patients or public health planning, respectively.
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Stud Health Technol Inform · Jan 2013
Development of a web-based observational tool for detecting intravenous medication errors with smart infusion pumps.
Computerized smart infusion pumps have been widely implemented to decrease the rate of intravenous (IV) medication errors in hospitals. However, these devices have not always achieved their potential, and important IV errors still persist. ⋯ In this study, we developed an observational tool to capture IV medication errors through iterative participatory design with interdisciplinary experts and then tested the tool by using incident cases regarding smart pump errors. We found that the tool could capture all smart infusion pump errors and is ready for testing for use as standard data collection tool in different hospital settings.
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Stud Health Technol Inform · Jan 2013
Understanding how clinical judgement and communicative practices interact with the use of an electronic clinical handover system.
Clinical handover is a high risk scenario involving the transfer of information, responsibility and accountability for patient care. Many strategies have been proposed to improve clinical handover and reduce risks it can pose to the safety and quality of patient care. ⋯ This research examines these issues based on evidence generated from a user-centred approach involving clinicians in the development and implementation of an electronic clinical handover system. The paper highlights how clinical judgements and communicative practices interact with an electronic clinical handover system, and discusses their potential implications for patient safety as part of a broader clinical handover improvement project.
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Stud Health Technol Inform · Jan 2013
Observational StudyWhiteboard icons to support the blood-test process in an emergency department: an observational study of temporal patterns.
The competent treatment of emergency department (ED) patients requires an effective and efficient process for handling laboratory tests such as blood tests. This study investigates how ED clinicians go about the process, from ordering blood tests to acknowledging their results and, specifically, assesses the use of whiteboard icons to support this process. ⋯ The whiteboard icons, which indicate four temporally distinct steps in the blood-test process, support the nurses in maintaining the flow of patients through the ED and the physicians in assessing test results at timeouts. The main results of this study are, however, that the blood-test process is temporally and collaboratively complex, that the whiteboard icons pass by most of this complexity, that attending to the icons is yet another temporally sensitive activity to remember, and that whereas the assessment of test results is integral to patient treatment, the acknowledgement of having seen the results is a formal add-on, the responsibility for which is sometimes unclear.
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Stud Health Technol Inform · Jan 2013
International priorities for research in nursing informatics for patient care.
The Nursing Informatics International Research Network (NIIRN) is a group of experts who are collaborating on the development of internationally relevant research programs for nursing informatics. In this paper we outline key findings of a survey exploring international research priorities for nursing informatics. The survey was available online during May-August 2012. ⋯ The two most highly ranked areas of importance for research were development of systems to provide real time feedback to nurses and assessment of the impact of HIT on nursing care and patient outcomes. The lowest ranked research topics were theory development and integrating genomic data into clinical information systems. The identification of these priorities provides a basis for future international collaborative research in the field of nursing informatics.