Zielstorff R D, Estey G, Vickery A, Hamilton G, Fitzmaurice J B, Barnett G O
Laboratory of Computer Science, Massachusetts General Hospital, Boston 02114, USA.
Proc AMIA Annu Fall Symp. 1997:248-52.
A decision support system for prevention and management of pressure ulcers was developed based on AHCPR guidelines and other sources. The system was implemented for 21 weeks on a 20-bed clinical care unit. Fifteen nurses on that unit volunteered as subjects of the intervention to see whether use of the system would have a positive effect on their knowledge about pressure ulcers and on their decision-making skills related to this topic. A similar care unit was used as a control. In addition, the system was evaluated by experts for its instructional adequacy, and by end users for their satisfaction with the system. Preliminary results show no effect on knowledge about pressure ulcers and no effect on clinical decision making skills. The system was rated positively for instructional adequacy, and positively for user satisfaction. User interviews related to satisfaction supplemented the quantitative findings. A discussion of the issues of conducting experiments like this in today's clinical environment is included.
基于美国医疗保健政策与研究机构（AHCPR）指南及其他资料，开发了一个用于预防和处理压疮的决策支持系统。该系统在一个拥有20张床位的临床护理单元实施了21周。该单元的15名护士自愿成为干预对象，以观察使用该系统是否会对她们关于压疮的知识以及与该主题相关的决策技能产生积极影响。一个类似的护理单元用作对照。此外，专家对该系统的教学充分性进行了评估，终端用户对该系统的满意度也进行了评估。初步结果显示，该系统对压疮知识和临床决策技能均无影响。该系统在教学充分性方面得到了积极评价，用户满意度也较高。与满意度相关的用户访谈补充了定量研究结果。本文还讨论了在当今临床环境中进行此类实验的相关问题。
