Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Klinik für Anästhesiologie mit Schwerpunkt operative Intensivmedizin (CCM, CVK), Berlin, Germany.
Medizinische Hochschule Hannover, Klinik für Anästhesiologie und Intensivmedizin, Hannover, Germany.
Int J Med Inform. 2018 Dec;120:8-13. doi: 10.1016/j.ijmedinf.2018.09.018. Epub 2018 Sep 19.
Critical care information systems (CCIS) are computer software systems specialized for supporting the data processing tasks of clinical staff in intensive care units (ICUs). Reports on the impact of CCIS vary strongly from large benefits to harmful impact. One factor causing these inconsistent results is a large functional heterogeneity of the currently available systems, as no standards exist. Therefore, the aim of this study was to derive recommendations for a minimum range of functions that CCIS should incorporate from the perspective of clinical users.
We performed a web-based survey targeting clinical ICU staff in Germany. Participants rated the usefulness of pre-defined CCIS functions (36 for physicians / 31 for nurses) between 0-5. To capture confounders that might influence the ratings, we recorded 18 individual and workplace characteristics.
The 912 participants rated all but three of the investigated functions as useful with median scores of 4-5. A multivariable analysis showed that the ratings were influenced by whether CCIS were used on the participants' wards, by the rating of the function quality of the used CCIS, the years of work experience and whether the participant was a physician or a nurse.
Clinical ICU staff considers all but three of the here investigated CCIS functions as useful. Even though we identified a variety of factors influencing the usefulness ratings, their influence is rather small and thus does not limit the validity of our findings. Accordingly, we commend the functions identified as useful to be incorporated in CCIS.
重症监护信息系统(CCIS)是专门用于支持重症监护病房(ICU)临床工作人员数据处理任务的计算机软件系统。关于 CCIS 影响的报告差异很大,从巨大的益处到有害的影响都有。造成这些不一致结果的一个因素是目前可用系统的功能具有很大的异质性,因为没有标准。因此,本研究的目的是从临床用户的角度出发,为 CCIS 应包含的最小功能范围提出建议。
我们针对德国临床 ICU 工作人员进行了一项基于网络的调查。参与者对预先定义的 CCIS 功能(医师 36 项/护士 31 项)的有用性进行了 0-5 的评分。为了捕捉可能影响评分的混杂因素,我们记录了 18 个个人和工作场所特征。
912 名参与者对所有调查功能中的 35 项功能进行了评分,除了三项功能外,其余功能的评分均为 4-5 分。多变量分析表明,评分受到 CCIS 是否在参与者所在病房使用、使用的 CCIS 功能质量评分、工作年限以及参与者是医师还是护士的影响。
临床 ICU 工作人员认为所有调查的 CCIS 功能中,只有三项功能不被认为是有用的。尽管我们确定了许多影响有用性评分的因素,但它们的影响相对较小,因此不会限制我们发现的有效性。因此,我们建议将被认为有用的功能纳入 CCIS。