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成人重症监护中营养和血糖管理新工具的可用性研究:GlucoSafe 2。

Usability study of a new tool for nutritional and glycemic management in adult intensive care: Glucosafe 2.

机构信息

Division of Intensive Care, Department of Acute Medicine (DMA), Geneva University Hospital, Geneva, Switzerland.

Nutrition Unit, Geneva University Hospital, Geneva, Switzerland.

出版信息

J Clin Monit Comput. 2021 May;35(3):525-535. doi: 10.1007/s10877-020-00502-1. Epub 2020 Mar 27.

Abstract

The new decision support tool Glucosafe 2 (GS2) is based on a mathematical model of glucose and insulin dynamics, designed to assist caregivers in blood glucose control and nutrition. This study aims to assess end-user acceptance and usability of this bedside decision support tool in an adult intensive care setting. Caregivers were first trained and then invited to trial GS2 prototype on bedside computers. Data for qualitative analysis were collected through semi-structured interviews from twenty users after minimum three trial days. Most caregivers (70%) rated GS2 as convenient and believed it would help improving adherence to current guidelines (85%). Moreover, most nurses (80%) believed that GS2 would be timesaving. Nurses' risk perceptions and manual data entry emerged as central barriers to use GS2 in routine practice. Issues emerged from the caregivers were compiled into a list of 12 modifications of the GS2 prototype to increase end-user acceptance and usability. This usability study showed that GS2 was considered by ICU caregivers as helpful in daily clinical practice, allowing time-saving and better standardization of ICU patient's care. Important issues were raised by the users with implications for the development and deployment of GS2. Integrating the technology into existing IT infrastructure may facilitate caregivers' acceptance. Further clinical studies of the performance and potential health outcomes are warranted.

摘要

新的决策支持工具 Glucosafe 2(GS2)基于葡萄糖和胰岛素动力学的数学模型,旨在帮助护理人员控制血糖和营养。本研究旨在评估这种床边决策支持工具在成人重症监护环境中的最终用户接受度和可用性。护理人员首先接受培训,然后邀请他们在床边计算机上试用 GS2 原型。在至少三天的试用后,通过对 20 名用户的半结构化访谈收集定性分析数据。大多数护理人员(70%)认为 GS2 很方便,并认为它将有助于提高对现有指南的依从性(85%)。此外,大多数护士(80%)认为 GS2 将节省时间。护士的风险感知和手动数据输入成为在常规实践中使用 GS2 的主要障碍。从护理人员那里收集的问题被汇编成一份 GS2 原型的 12 项修改清单,以提高最终用户的接受度和可用性。这项可用性研究表明,GS2 被 ICU 护理人员认为在日常临床实践中有帮助,可以节省时间,更好地规范 ICU 患者的护理。用户提出了重要问题,对 GS2 的开发和部署具有启示意义。将该技术集成到现有的 IT 基础设施中可能会提高护理人员的接受度。需要进一步研究该技术的性能和潜在健康结果。

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