Zaidi Syed Tabish Razi, Marriott Jennifer L
Clinical Pharmacist, Pharmaceutical Care, King Abdulaziz Medical City, Al Ahsa, Saudi Arabia.
South Med Rev. 2012 Dec;5(2):42-50. Epub 2012 Dec 27.
To measure clinicians' perceptions of barriers and facilitators to the adoption of a Computerised Decision Support System (CDSS) for antibiotic approval, and to examine the correlation between these perceptions and actual usage of the system by clinicians.
This study was conducted in a tertiary care university hospital of Melbourne, Australia. A survey tool comprising of demographic items and newly developed scales to measure clinicians' perceptions of barriers and facilitators to use of an CDSS was developed. Cross-sectional mail surveys were sent to 250 Junior and Senior Medical Staff and Pharmacists in a tertiary care hospital. Cronbach's alpha was used to measure the reliability of the perceptions scales. One way ANOVA was used to assess the differences between participants' responses; Tamhane's test was used for post-hoc analysis. Pearson correlations were used to measure the relationship between the participants' scores on the scales and their actual use of the CDSS under study.
The overall survey response rate was 54%. Cronbach's alpha for the perceived barrier and facilitator scales were 0.80 and 0.88, respectively. Senior medical staff perceived significantly more barriers than junior medical staff and pharmacists. Statistically significant differences were observed between the scores of the participants on a number of items on the perceived barriers and facilitators scales. Negative correlations were observed between the participants' scores on the perceived barriers scale and their use of the system. (r= -0.415, p= 0.001).
The scales to measure perceived barriers and facilitators to adopt antibiotic CDSS have shown acceptable reliability and validity measures. Important differences exist between senior and junior medical staff about the barriers and facilitators to adopting the CDSS which may influence future use by clinicians.
衡量临床医生对于采用计算机化决策支持系统（CDSS）进行抗生素审批的障碍和促进因素的看法，并研究这些看法与临床医生对该系统实际使用情况之间的相关性。
本研究在澳大利亚墨尔本的一家三级护理大学医院进行。开发了一种调查工具，其中包括人口统计学项目以及用于衡量临床医生对使用CDSS的障碍和促进因素看法的新制定量表。向一家三级护理医院的250名初级和高级医务人员及药剂师发送了横断面邮件调查。使用Cronbach's alpha系数来衡量看法量表的信度。采用单因素方差分析来评估参与者回答之间的差异；使用Tamhane检验进行事后分析。使用Pearson相关性分析来衡量参与者在量表上的得分与他们对所研究的CDSS的实际使用之间的关系。
总体调查回复率为54%。感知障碍量表和促进因素量表的Cronbach's alpha系数分别为0.80和0.88。高级医务人员比初级医务人员和药剂师感知到的障碍明显更多。在感知障碍和促进因素量表上的一些项目上，参与者的得分之间观察到了具有统计学意义的差异。在感知障碍量表上参与者的得分与他们对系统的使用之间观察到负相关（r = -0.415，p = 0.001）。
用于衡量采用抗生素CDSS的感知障碍和促进因素的量表已显示出可接受的信度和效度指标。在采用CDSS的障碍和促进因素方面，高级和初级医务人员之间存在重要差异，这可能会影响临床医生未来的使用情况。
