Büssing A, Herbig B
Technical University Muenchen, Germany.
Comput Nurs. 1998 Nov-Dec;16(6):311-7; quiz 318-9.
In this article two recent developments in the German health care system are outlined. On one side, an increasing economic pressure and legal changes on the German health care system lead to growing computerization in German hospitals. On the other side, a shift from functional to holistic nursing is observed. The question is raised if within the paradigm of holistic nursing computer support is an adequate way to organize and design work. The newly developed German care information system, PIK (Pflegedienst im Krankenhaus--Nursing service in hospital), serves as an example for a program that is structured according to the nursing process. On the grounds of this exemplification it is argued that within the concept of "technology as an option" not only is the design of a program important but also its basic work organization and design. The authors come to the conclusion that computer support of holistic nursing is possible. However, it is shown that some aspects of nursing (for example, intuitive knowledge, which has been identified as an integral part of expert nursing) cannot be formalized and thus cannot be supported by computer systems.
本文概述了德国医疗保健系统最近的两项发展。一方面，德国医疗保健系统面临的经济压力不断增加以及法律变化导致德国医院的计算机化程度不断提高。另一方面，观察到护理模式从功能护理向整体护理转变。问题是在整体护理范式下，计算机支持是否是组织和设计工作的适当方式。新开发的德国护理信息系统PIK（Pflegedienst im Krankenhaus——医院护理服务）作为一个根据护理流程构建的程序示例。基于这个示例，有人认为在“技术作为一种选择”的概念中，不仅程序的设计很重要，其基本工作组织和设计也很重要。作者得出结论，整体护理的计算机支持是可能的。然而，研究表明护理的某些方面（例如，直观知识，已被确定为专家护理的一个组成部分）无法形式化，因此无法得到计算机系统的支持。
