Cunningham S, Deere S, Elton R A, McIntosh N
Department of Child Life and Health, University of Edinburgh, UK.
Int J Clin Monit Comput. 1996 Nov;13(4):235-41. doi: 10.1023/a:1016967407632.
To compare charting of physiological parameters manually by nurses and automatically by computer and so decide whether this task could accurately be performed by computer.
SUBJECTS/SETTING: 101 consecutive patients admitted for tertiary neonatal intensive care.
Direct comparison of 48 hours of data collected by both methods. Computer data stored each second and the hourly median compared with the single hourly value noted by the nurse.
All patients were monitored by standard patient monitor and a computer. Four physiological parameters were compared between nurse and computer (both derived information from the standard patient monitor): heart rate, transcutaneous oxygen, mean blood pressure, central temperature. A random 51% of patients had the computer data displayed as trends at the cotside. Comparison of the hourly nurse observation and a computer hourly median value. Computer data was compared before and after the removal of artifact. In addition, the effects on nursing observations of either display or non display of the computer trend data was assessed.
Nurse and computer observations were statistically significantly different (p < 0.001), though these were not clinically important. Nurses tended to note a higher figure than the computer median. The cotside display of computer data improved consistency between the nurse and computer observations. Artifact present in the data had little influence on the accuracy of the computer median value.
Computer systems can accurately chart physiological data, providing a more flexible record with a minimal risk to data reliability from artifact.
比较护士手动记录生理参数与计算机自动记录生理参数的情况，从而确定计算机能否准确执行这项任务。
研究对象/环境：101例连续入住三级新生儿重症监护病房的患者。
对两种方法收集的48小时数据进行直接比较。计算机每秒存储数据，并将每小时中位数与护士记录的单个每小时值进行比较。
所有患者均由标准患者监护仪和计算机进行监测。比较护士和计算机记录的四项生理参数（均从标准患者监护仪获取信息）：心率、经皮氧分压、平均血压、中心温度。随机抽取51%的患者，在病床边以趋势图形式显示计算机数据。比较护士每小时的观察结果与计算机每小时的中位数。去除伪迹前后对计算机数据进行比较。此外，评估计算机趋势数据显示或不显示对护理观察的影响。
护士和计算机的观察结果在统计学上有显著差异（p < 0.001），但这些差异在临床上并不重要。护士记录的数值往往高于计算机中位数。在病床边显示计算机数据可提高护士和计算机观察结果之间的一致性。数据中的伪迹对计算机中位数的准确性影响很小。
计算机系统能够准确记录生理数据，提供更灵活的记录，且因伪迹导致数据可靠性风险最小。
