Wallace C J, Metcalf S, Zhang X, Kinder A T, Greenway L, Morris A H
LDS Hospital Division of Pulmonary and Respiratory Care Services, Salt Lake City, Utah, USA.
Proc Annu Symp Comput Appl Med Care. 1995:810-3.
We implemented a computerized decision support tool to standardize the administration of supplemental oxygen (O2) therapy in the acute care (non-ICU) hospital setting. Caregiver acceptance of the computerizeds oxygen therapy protocol (COTP) instructions was measured to determine the clinical performance of the computerized decision support tool. 49.6% of instructions generated were followed by the clinical caregiver, and 16.8% of instructions generated were explicitly acknowledged by the user through the COTP computer interface. Despite this low caregiver response rate, significant favorable changes in the administration of oxygen were observed. This paper is focused on the issues of general importance the caregiver response rate raises for the implementation and clinical use of computerized decision support tools, including: (1) limitations of the user interface and (2) inherent difficulty in changing long-standing practice patterns.
我们实施了一种计算机化决策支持工具，以规范急性护理（非重症监护病房）医院环境中补充氧气（O2）治疗的管理。对护理人员对计算机化氧气治疗方案（COTP）指令的接受程度进行了测量，以确定该计算机化决策支持工具的临床性能。临床护理人员遵循了所生成指令的49.6%，并且用户通过COTP计算机界面明确确认了所生成指令的16.8%。尽管护理人员的回应率较低，但在氧气管理方面仍观察到了显著的积极变化。本文重点关注护理人员回应率给计算机化决策支持工具的实施和临床使用带来的具有普遍重要性的问题，包括：（1）用户界面的局限性，以及（2）改变长期实践模式的内在困难。
