Derleme
Yıl 2020,
Cilt: 8 Sayı: 2, 483 - 495, 21.06.2020
Öz
Klinik karar destek sistemleri, klinisyenlere klinik karar almaya yardımcı olmak için hastaya özgü değerlendirmeler veya öneriler sunan bilgisayar ya da kâğıt temelli sistemlerdir. Günümüzde insanlar tarafından başka şekilde elde edilemeyen veya yorumlanamayan verilerden ve gözlemlerden faydalanma kabiliyetine sahip nitelikler eklenerek daha da geliştirilmiştir. Özellikle sağlıkta klinik karar destek sistemlerinin kullanımına ilişkin sınırlı kaynak olsa da örnekler, meydana gelebilecek olumsuz olayları ya da hataları azaltacağı yönündedir. Bu derlemede; hemşirelik kararlarının kanıta dayalı bilgi ile birleştirilerek uygulamada kullanımını sağlayan klinik karar destek sistemlerinin avantajları, dezavantajları, kullanım alanları ve kullanımını etkileyen faktörlerin incelenmesi amaçlanmıştır. Sağlıkta, tanılama, alarm sistemleri, hastalık yönetimi, reçete ve ilaç kontrolü gibi amaçlarla geliştirilmiş bilgisayarlı hatırlatıcılar, dokümantasyon şablonları ve klinik iş akışı araçları mevcuttur. Karar destek sistemleri hemşireler tarafından bilgilerin kaydedilmesi, hastalık seyrinin izlenmesi, bakım ile ilgili hatırlatmalarda ve daha önce alınmış olan kararların teyit edilmesi gibi çeşitli şekillerde kullanılmıştır. Yapılan araştırmalar, hemşirelerin bilgi ve deneyimi, teknoloji sisteminin özellikleri ve örgütsel faktörler gibi çeşitli faktörlerin klinik karar destek sisteminin kullanılma şeklini etkileyebileceğini göstermiştir. Klinik karar destek sistemlerinin kullanımı hemşirenin karar vermesini kolaylaştırma, tıbbi hataları ve ilaç hata sayısını azaltma, bilgiye erişimi artırma, bakım kalitesinde tutarlığın sağlanması ve özgüveni artırma gibi faydaların yanı sıra hemşirelikte kanıta dayalı uygulamayı teşvik ettiği belirlenmiştir..
Anahtar Kelimeler
Hemşirelik Hemşirelik Bilişimi Klinik Karar Destek Sistemleri
Destekleyen Kurum
Yoktur
Proje Numarası
-
Teşekkür
-
Kaynakça
- Agharezaei, Z., Bahaadinbeigy, K., Tofighi, S., Agharezaei, L., ve Nemati A. (2014). Attitude of Iranian physicians and nurses toward a clinical decision support system for pulmonary embolism and deep vein thrombosis.Computer Methods and Programs in Biomedicine, 115(2), 95-101.
- Bates, D.W., ve Hug, B.L. (2014). Clinical decision support systems. Swiss Medical Weekly, 144:1407, :1-7.
- Bolat, O., Gulenc, N., Ozkan, E., Aydin, N., ve Kose, I. (2020). The Effects of a Nursing Care Plan Incorporated with a Decision Support System on Ventilator Associated Pneumonia: A Case Study. In Proceedings of the 13th International Joint Conference on Biomedical Engineering Systems and Technologies. BIOSTEC. 5, 693-698
- Castıllo, R.S., ve Kelemen, A. (2013). Considerations for a Successful Clinical Decision Support System. CIN: Computers, Informatics, Nursing, 31(7), 319–326.
- Crabb, D.B., Hurwitz, J.E., Reed, A.C., Smith, Z.J., Martin. E.T., Tyndall, J.A., Taasan, M.V., Plourde, M.A., Beattie, L.K..(2020). Innovation in resuscitation: A novel clinical decision display system for advanced cardiac life support. Am J Emerg Med, S0735-6757, (20)30149. DOI: https://doi.org/10.1016/j.ajem.2020.03.007
- Delbanco, T., Walker, J., Bell, S.K., Darer, J.D., Elmore, J.G., Farag, N., Feldman, H.J., Mejilla, R., Ngo, L., Ralston, J.D., Ross, S.E., Trivedi, N., Vodicka, E., Leveille, S.G. (2012). Inviting patients to read their doctors’ notes: A Quasi-experimental study and a look ahead. Ann Intern Med, 157(7), 461–470.
- Fossum, M., Alexander, G.L., Ehnfors, M., ve Ehrenberg, A. (2011). Effects of a computerized decision support system on pressure ulcers and malnutrition in nursing homes for the elderly. International Journal of Medical Informatics, 80, 607–617.
- Gebru, A.A., Yimam, Y., Nigussie, A.W., Kahsay, W.E., Gelaye, N.D., ve Mengistie, Z. (2015). Clinical decision support system in nursing: A review of literature. Indian Journal of Basic and Applied Medical Research, 4(2), 437-452.
- Gonçalves, L.S., Amaro, M.L.M., Romero, A.L.M., Schamne, F.K., Fressatto, J.L., ve Bezerra, C.W. (2020). Implementation of an Artificial Intelligence Algorithm for sepsis detection. Rev Bras Enferm, 73(3). https://doi.org/10.1590/0034-7167-2018-0421
- Handler, S.M., Hudak, S.S., ve Ouslander, J.G. (2011). Incorporating INTERACT II Clinical Decision Support Tools into Nursing Home Health Information Technology. Ann Longterm Care, 19(11), 23-26.
- HeathİT.gov. What is computerized provider order entry?. 18.04.2020 tarihinde .https://www.healthit.gov/faq/what-computerized-provider-order-entry Erişim Tarihi:
- Kawamoto, K., Houlihan, C., Balas, A., ve Lobach, D. (2005). Improving clinical practice using clinical decision support systems: a systematic review of trials to identify features critical to success. British Medical Journal, 330, 765–772
- Kobak, R.R., Cole, H., Ferenz-Gillies, R., Fleming, W., ve Gamble, W. (1993). Attachment and emotion regulation during mother-teen problem-solving: A control theory analysis. Child Development, 64, 231–245.
- Mendi, B. (2016). Health Informatics and Current Applications. Mendi B. Telemedicine. 1. Baskı.İstanbul: Nobel Tıp Kitabevi, 149-161.
- Müller-Staub M. ve Paans W. A Standard for Nursing Process -Clinical Decision Support Systems (NP-CDSS). Stud Health Technol Inform. 2016;225:810-1.
- North, F.R.D., Bremseth, K.A., Lee, M.R., Cox, D.L., Varkey, P., ve Stroebel, R.J. (2014). Clinical decision support improves quality of telephone triage documentation - an analysis of triage documentation before and after computerized clinical decision support. BMC Medical Informatics and Decision Making, 14, 20.
- Lopez, K.D., Gephart, S.M., Raszewski, R., Sousa, V., Shehorn, L.E., ve Abraham, J.(2017). Integrative review of clinical decision support for registered nurses in acute care settings Journal of the American Medical Informatics Association, 24(2), 441–450.
- Lyerla, F. (2008). Design and implementation of a nursing clinical decision support system to promote guideline adherence. CIN: Computers, Informatics, Nursing, 26(4), 227-233.
- Ömürbek, N., ve Altın, F.G. (2009). A Study On Healthcare Information Systems Use In Hospitals: The Case Of İzmir. SDÜ Fen Edebiyat Fakültesi Sosyal Bilimler Dergisi, 19, 211-232.
- O'Neill, E.S., Dluhy, N.M., ve Ryan, J.R. (2004). Coupling the N-CODES system with actual nurse decision- making. CIN Computers Informatics Nursing, 24(1), 28-34.
- Padden, J.S., McBride, S., Tietze, M., Nelson, T., ve Eckbard, M. (2019). Clinical Decision Support System. Nursıng Informatıon fort he Advanced Practice Nurse 2.st Edıt. Mcbride S., Tietze M. New York: Springer Publishing Company.
- Pıscotty, R., ve Kalısch, B. (2014). Nurses’ Use of Clinical Decision Support: A Literature Review.. Computers Informatics Nursing, 32(12), 562-568.
- Poole, S. (2004). Providing Telephone Triage and Advice in a Family Practice. Elk Grove Village, Illinois: American Academy of Pediatrics.
- Purkuloğlu, E., Ün, Ü., ve Yürürdurmaz, F. (2019). Hemşire Karar Destek Sistemleri Uygulamaları. Hacettepe Sağlık İdaresi Dergisi, 22(3), 491-514
- Uslu, D., Toygar, Ş.A., ve Mansur, F. (2016). Hastane Bilgi Yönetim Sisteminin Kullanılabilirliğini Belirlemeye Yönelik Bir Araştırma. Uluslararası Sağlık Yönetimi ve Stratejileri Araştırma Dergisi, 2(3), 45-57.
- Scott, L.D., Rogers, A.E., Hwang, W.T., ve Zhang, Y. (2006). Effects of critical care nurses' work hours on vigilance and patients' safety. Am J Crit Care, 15 (1), 30-7.
- Terlemez, B., Şahin, D., ve Dilek, F. (2014). Namık Kemal Üniversitesi Sağlık Uygulama ve Araştırma Merkezindeki Tıbbi Sekreterler ve İdari Personelin Bilgi ve Arşiv Sistemleri Hakkındaki Düşünceleri. Electronic Journal of Vocational Colleges, 4(3), 364-378.
- Wasylewicz, A.T.M., van Grinsven, R.J.B., Bikker, J.M.W., Korsten, E.M., Egberts, T.C.G., Kerskes, M.H.M., ve Grouls, R.J.E. (2020). CDSS assisted pharmacy intervention reduces feeding tube-related medication errors in hospitalized patients: a focus on medication suitable for feeding tube administration. J Parenter Enteral Nutr. doi: 10.1002/jpen.1869.
- Yılmaz, A.A., ve Ozdemir, L. (2015) Development and Implementation of the Clinical Decision Support System for Patients With Cancer and Nurses' Experiences Regarding the System. International Journal of NursingKnowledge, 28(1), 4-12.
Yıl 2020,
Cilt: 8 Sayı: 2, 483 - 495, 21.06.2020
Öz
Clinical Decision Support Systems are computer or paper based systems that provide patient-specific assessments or recommendations to help clinicians make clinical decisions. These systems, have been further developed today by adding attributes that are capable of taking advantage of data and observations that could not otherwise be obtained or interpreted by humans. In particular, although there are limited resources for the use of Clinical Decision Support Systems in healthcare, examples suggest that it will reduce negative events or errors that may occur. In this review, it is aimed to examine the Clinical Decision Support Systems’ -which enable nursing decisions to be combined with evidence-based knowledge and used in practice-; advantages, disadvantages, usage and the factors affecting the usage. In healthcare; computerized reminders, documentation templates, and clinical work-flow tools which have been developed for diagnostics, alarm systems, disease management, prescription and drug control purposes, are available. Decision support systems have been used by nurses in a variety of ways, such as recording information, monitoring the course of illness, reminders about care and confirming previously-made decisions. Researches have shown that various factors such as nurses' knowledge and experience, characteristics of the technology system and organizational factors can influence the Clinical Decision Support System’s usage way. The use of clinical decision support systems promotes evidence-based practice in nursing as well as benefits in; facilitating the decision-making of the nurse, reducing medical errors and the number of drug errors, increasing access to information, maintaining consistency in quality of care and increasing self-confidence.
Anahtar Kelimeler
Nursing Nursing Informatics Clinical Decision Support Systems
Proje Numarası
-
Kaynakça
- Agharezaei, Z., Bahaadinbeigy, K., Tofighi, S., Agharezaei, L., ve Nemati A. (2014). Attitude of Iranian physicians and nurses toward a clinical decision support system for pulmonary embolism and deep vein thrombosis.Computer Methods and Programs in Biomedicine, 115(2), 95-101.
- Bates, D.W., ve Hug, B.L. (2014). Clinical decision support systems. Swiss Medical Weekly, 144:1407, :1-7.
- Bolat, O., Gulenc, N., Ozkan, E., Aydin, N., ve Kose, I. (2020). The Effects of a Nursing Care Plan Incorporated with a Decision Support System on Ventilator Associated Pneumonia: A Case Study. In Proceedings of the 13th International Joint Conference on Biomedical Engineering Systems and Technologies. BIOSTEC. 5, 693-698
- Castıllo, R.S., ve Kelemen, A. (2013). Considerations for a Successful Clinical Decision Support System. CIN: Computers, Informatics, Nursing, 31(7), 319–326.
- Crabb, D.B., Hurwitz, J.E., Reed, A.C., Smith, Z.J., Martin. E.T., Tyndall, J.A., Taasan, M.V., Plourde, M.A., Beattie, L.K..(2020). Innovation in resuscitation: A novel clinical decision display system for advanced cardiac life support. Am J Emerg Med, S0735-6757, (20)30149. DOI: https://doi.org/10.1016/j.ajem.2020.03.007
- Delbanco, T., Walker, J., Bell, S.K., Darer, J.D., Elmore, J.G., Farag, N., Feldman, H.J., Mejilla, R., Ngo, L., Ralston, J.D., Ross, S.E., Trivedi, N., Vodicka, E., Leveille, S.G. (2012). Inviting patients to read their doctors’ notes: A Quasi-experimental study and a look ahead. Ann Intern Med, 157(7), 461–470.
- Fossum, M., Alexander, G.L., Ehnfors, M., ve Ehrenberg, A. (2011). Effects of a computerized decision support system on pressure ulcers and malnutrition in nursing homes for the elderly. International Journal of Medical Informatics, 80, 607–617.
- Gebru, A.A., Yimam, Y., Nigussie, A.W., Kahsay, W.E., Gelaye, N.D., ve Mengistie, Z. (2015). Clinical decision support system in nursing: A review of literature. Indian Journal of Basic and Applied Medical Research, 4(2), 437-452.
- Gonçalves, L.S., Amaro, M.L.M., Romero, A.L.M., Schamne, F.K., Fressatto, J.L., ve Bezerra, C.W. (2020). Implementation of an Artificial Intelligence Algorithm for sepsis detection. Rev Bras Enferm, 73(3). https://doi.org/10.1590/0034-7167-2018-0421
- Handler, S.M., Hudak, S.S., ve Ouslander, J.G. (2011). Incorporating INTERACT II Clinical Decision Support Tools into Nursing Home Health Information Technology. Ann Longterm Care, 19(11), 23-26.
- HeathİT.gov. What is computerized provider order entry?. 18.04.2020 tarihinde .https://www.healthit.gov/faq/what-computerized-provider-order-entry Erişim Tarihi:
- Kawamoto, K., Houlihan, C., Balas, A., ve Lobach, D. (2005). Improving clinical practice using clinical decision support systems: a systematic review of trials to identify features critical to success. British Medical Journal, 330, 765–772
- Kobak, R.R., Cole, H., Ferenz-Gillies, R., Fleming, W., ve Gamble, W. (1993). Attachment and emotion regulation during mother-teen problem-solving: A control theory analysis. Child Development, 64, 231–245.
- Mendi, B. (2016). Health Informatics and Current Applications. Mendi B. Telemedicine. 1. Baskı.İstanbul: Nobel Tıp Kitabevi, 149-161.
- Müller-Staub M. ve Paans W. A Standard for Nursing Process -Clinical Decision Support Systems (NP-CDSS). Stud Health Technol Inform. 2016;225:810-1.
- North, F.R.D., Bremseth, K.A., Lee, M.R., Cox, D.L., Varkey, P., ve Stroebel, R.J. (2014). Clinical decision support improves quality of telephone triage documentation - an analysis of triage documentation before and after computerized clinical decision support. BMC Medical Informatics and Decision Making, 14, 20.
- Lopez, K.D., Gephart, S.M., Raszewski, R., Sousa, V., Shehorn, L.E., ve Abraham, J.(2017). Integrative review of clinical decision support for registered nurses in acute care settings Journal of the American Medical Informatics Association, 24(2), 441–450.
- Lyerla, F. (2008). Design and implementation of a nursing clinical decision support system to promote guideline adherence. CIN: Computers, Informatics, Nursing, 26(4), 227-233.
- Ömürbek, N., ve Altın, F.G. (2009). A Study On Healthcare Information Systems Use In Hospitals: The Case Of İzmir. SDÜ Fen Edebiyat Fakültesi Sosyal Bilimler Dergisi, 19, 211-232.
- O'Neill, E.S., Dluhy, N.M., ve Ryan, J.R. (2004). Coupling the N-CODES system with actual nurse decision- making. CIN Computers Informatics Nursing, 24(1), 28-34.
- Padden, J.S., McBride, S., Tietze, M., Nelson, T., ve Eckbard, M. (2019). Clinical Decision Support System. Nursıng Informatıon fort he Advanced Practice Nurse 2.st Edıt. Mcbride S., Tietze M. New York: Springer Publishing Company.
- Pıscotty, R., ve Kalısch, B. (2014). Nurses’ Use of Clinical Decision Support: A Literature Review.. Computers Informatics Nursing, 32(12), 562-568.
- Poole, S. (2004). Providing Telephone Triage and Advice in a Family Practice. Elk Grove Village, Illinois: American Academy of Pediatrics.
- Purkuloğlu, E., Ün, Ü., ve Yürürdurmaz, F. (2019). Hemşire Karar Destek Sistemleri Uygulamaları. Hacettepe Sağlık İdaresi Dergisi, 22(3), 491-514
- Uslu, D., Toygar, Ş.A., ve Mansur, F. (2016). Hastane Bilgi Yönetim Sisteminin Kullanılabilirliğini Belirlemeye Yönelik Bir Araştırma. Uluslararası Sağlık Yönetimi ve Stratejileri Araştırma Dergisi, 2(3), 45-57.
- Scott, L.D., Rogers, A.E., Hwang, W.T., ve Zhang, Y. (2006). Effects of critical care nurses' work hours on vigilance and patients' safety. Am J Crit Care, 15 (1), 30-7.
- Terlemez, B., Şahin, D., ve Dilek, F. (2014). Namık Kemal Üniversitesi Sağlık Uygulama ve Araştırma Merkezindeki Tıbbi Sekreterler ve İdari Personelin Bilgi ve Arşiv Sistemleri Hakkındaki Düşünceleri. Electronic Journal of Vocational Colleges, 4(3), 364-378.
- Wasylewicz, A.T.M., van Grinsven, R.J.B., Bikker, J.M.W., Korsten, E.M., Egberts, T.C.G., Kerskes, M.H.M., ve Grouls, R.J.E. (2020). CDSS assisted pharmacy intervention reduces feeding tube-related medication errors in hospitalized patients: a focus on medication suitable for feeding tube administration. J Parenter Enteral Nutr. doi: 10.1002/jpen.1869.
- Yılmaz, A.A., ve Ozdemir, L. (2015) Development and Implementation of the Clinical Decision Support System for Patients With Cancer and Nurses' Experiences Regarding the System. International Journal of NursingKnowledge, 28(1), 4-12.
Toplam 29 adet kaynakça vardır.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Klinik Tıp Bilimleri |
| Bölüm | Derleme |
| Yazarlar | |
| Proje Numarası | - |
| Yayımlanma Tarihi | 21 Haziran 2020 |
| Gönderilme Tarihi | 27 Mayıs 2020 |
| Kabul Tarihi | 8 Haziran 2020 |
| Yayımlandığı Sayı | Yıl 2020 Cilt: 8 Sayı: 2 |
