儿科患者病情恶化早期预警临床决策支持系统构建及应用评价
Construction and Application Evaluation of Clinical Decision Support System of Early Warning for Pediatric Deterioration
章莹莹 1张晓波 2陆国平 1黄勤 3王颖雯 3傅唯佳 4胡静 3沈伟杰 1杨玉霞 1顾莺3
作者信息
- 1. 复旦大学附属儿科医院 重症医学科,上海 201102
- 2. 复旦大学附属儿科医院 呼吸科
- 3. 复旦大学附属儿科医院 护理部
- 4. 复旦大学附属儿科医院 信息科
- 折叠
摘要
目的 构建并评价儿科患者病情恶化早期风险评估及预警决策支持系统(intelligent risk assessment and early warn-ing system,IRA-EWS).方法 以临床决策支持系统参考模型(clinical decision support system-reference model,CDSS-RM)为理论框架,以半结构式访谈提炼 IRA-EWS功能清单,以专家论证会讨论完成系统设计.采用临床护理信息系统有效性评价量表进行 IRA-EWS的应用评价.结果 IRA-EWS包括以下功能:颜色预警,以红黄绿代表高中低程度的病情恶化预警级别;评估触发,基于结构化字段自动触发儿童早期预警评分(pediatric early warning score,PEWS)评估;决策支持,基于不同预警级别的护理计划予以决策支持;趋势展示,以可视化图表呈现单次住院周期内PEWS评分趋势;数据共享,医护实时共享中高风险预警.临床护士对 IRA-EWS的使用体验平均得分为(97.46±0.90)分,得分最高的维度是"用户满意",最低的是"系统质量".结论 基于 CDSS-RM并评估临床护士需求,IRA-EWS的构建过程是科学的,护士对 IRA-EWS有良好体验,后续还需对其是否可以改善患者结局作有效性评价.
Abstract
Objective To develop and evaluate an Intelligent Risk Assessment and Early Warning System(IRA-EWS)for pediatric deterioration.Methods The clinical decision support system reference model(CDSS-RM)was used as the theoretical framework.The list of functions of IRA-EWS was refined through semi-structured interviews,and the system was designed through expert discussion and validation.The clin-ical nursing information system effectiveness evaluation scale was used to evaluate the application of IRA-EWS.Results The IRA-EWS included the following functions:color alerts with red,yellow and green re-presenting high,medium and low deterioration alert levels;assessment triggers,which automatically trig-gered the Pediatric Early Warning Score(PEWS)assessment based on structured fields;decision support,which provided decision support based on nursing plans of different early warning levels;trend display,which visualized the trend of PEWS scores in a single hospitalization cycle;data sharing,which was a real-time sharing of medium-and high-risk early warning between doctors and nurses.The average score of clin-ical nurses'experience of using IRA-EWS was 97.46±0.90,with the highest score being"user satisfac-tion"and the lowest being"system quality".Conclusions Based on CDSS-RM and the evaluation of the needs of clinical nurses,the construction process of IRA-EWS is scientific.Nurses have a favorable experi-ence of using IRA-EWS and it is necessary to evaluate its effectiveness in improving patient outcomes in the future.
关键词
儿童早期预警评分/临床决策支持系统/护理信息Key words
pediatric early warning score/clinical decision support system/nursing information引用本文复制引用
基金项目
国家重点研发计划(2021YFC2701800)
国家重点研发计划(2021YFC2701805)
复旦大学附属儿科医院临床研究中心大数据与人工智能研究项目(2020DSJ09)
出版年
2024
NETL
NSTL
维普
万方数据