Happ B A
Analytic Sciences Corporation (TASC), Arlington, VA.
Proc Annu Symp Comput Appl Med Care. 1993:183-7.
It is thought that new technologies like computers at the patient's bedside, or point of care technology (PCT) improve nursing productivity, documentation, patient satisfaction and decrease costs. Using the Health Care Technology Assessment (HCTA) framework, (safety, cost, effectiveness, social impact), a descriptive and quasi-experimental study was performed to test the effectiveness and explain the social impact of PCT. A sample of 90 patients from five nursing units in three hospitals were obtained for the study. Half of the patients had computers at their bedside. Data were collected on a hospital pretest/posttest unit and two comparison and experimental units. The main null hypothesis was: There is no difference in the quality of patient care on nursing units with and without PCT. Quality of patient care was measured by patient satisfaction and a nursing care documentation instruments. This hypothesis was rejected. While patients were generally very satisfied with their nursing care on all units, when controlling for time and the presence of the computer, patients who did not have PCT were more satisfied than patients in rooms with PCT. Furthermore, the charts of patients with PCT were less compliant to documentation standards. Conversely, a sub sample of these same patients expressed positive responses to the bedside computer and technologies in their room and this concurred with the current literature. The benefits of the technology were found to outweigh the costs of PCT from the literature review. There was not enough in the literature to draw conclusions about the safety of PCT. In summary, the quality of patient care did not improve with the implementation of PCT in this study.(ABSTRACT TRUNCATED AT 250 WORDS)
人们认为,诸如患者床边配备电脑等新技术,即床边护理技术(PCT),能够提高护理工作效率、完善护理记录、提升患者满意度并降低成本。本研究运用医疗保健技术评估(HCTA)框架(安全性、成本、有效性、社会影响),开展了一项描述性和准实验性研究,以检验PCT的有效性并阐释其社会影响。研究从三家医院的五个护理单元选取了90名患者作为样本。其中一半患者床边配备了电脑。数据收集于医院的一个预测试/后测试单元以及两个对照和实验单元。主要原假设为:配备和未配备PCT的护理单元在患者护理质量上不存在差异。患者护理质量通过患者满意度和一份护理记录工具进行衡量。该假设被否决。虽然所有单元的患者总体上对护理都非常满意,但在控制时间和电脑配备情况后,未配备PCT的患者比配备PCT病房的患者更满意。此外,配备PCT患者的病历对记录标准的依从性较低。相反,这些患者中的一个子样本对床边电脑及病房中的技术表达了积极反馈,这与当前文献相符。从文献综述来看,该技术的益处超过了PCT的成本。文献中没有足够信息得出关于PCT安全性的结论。总之,在本研究中,实施PCT并未提高患者护理质量。(摘要截选至250词)