Int J Med Inform - Nursing process decision support system for urology ward.


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RPOSE: We developed a nursing process decision support system (NPDSS) based on three clinical pathways, including benign prostatic hypertrophy, inguinal hernia, and urinary tract stone. NPDSS included six major nursing diagnoses - acute pain, impaired urinary elimination, impaired skin integrity, anxiety, infection risk, and risk of falling. This paper aims to describe the design, development and validation process of the NPDSS.METHODS: We deployed the Delphi method to reach consensus for decision support rules of NPDSS. A team of nine-member expert nurses from a medical center in Taiwan was involved in Delphi method. The Cronbach's a method was used for examining the reliability of the questionnaire used in the Delphi method. The Visual Basic 6.0 as front-end and Microsoft Access 2003 as back-end was used to develop the system. A team of six nursing experts was asked to evaluate the usability of the developed systems. A 5-point Likert scale questionnaire was used for the evaluation. The sensitivity and specificity of NPDSS were validated using 150 nursing chart.RESULTS: The study showed a consistency between the diagnoses of the developed system (NPDSS) and the nursing charts. The sensitivities of the nursing diagnoses including acute pain, impaired urinary elimination, risk of infection, and risk of falling were 96.9%, 98.1%, 94.9%, and 89.9% respectively; and the specificities were 88%, 49.5%, 62%, and 88% respectively. We did not calculate the sensitivity and specificity of impaired skin integrity and anxiety due to non-availability of enough sample size.CONCLUSIONS: NPDSS can help nurses in decision making of nursing diagnoses. Besides, it can help them to generate nursing diagnoses based on patient-specific data, individualized care plans, and implementation within their usual nursing workflow.

Resumo Limpo

rpose develop nurs process decis support system npdss base three clinic pathway includ benign prostat hypertrophi inguin hernia urinari tract stone npdss includ six major nurs diagnos acut pain impair urinari elimin impair skin integr anxieti infect risk risk fall paper aim describ design develop valid process npdssmethod deploy delphi method reach consensus decis support rule npdss team ninememb expert nurs medic center taiwan involv delphi method cronbach method use examin reliabl questionnair use delphi method visual basic frontend microsoft access backend use develop system team six nurs expert ask evalu usabl develop system point likert scale questionnair use evalu sensit specif npdss valid use nurs chartresult studi show consist diagnos develop system npdss nurs chart sensit nurs diagnos includ acut pain impair urinari elimin risk infect risk fall respect specif respect calcul sensit specif impair skin integr anxieti due nonavail enough sampl sizeconclus npdss can help nurs decis make nurs diagnos besid can help generat nurs diagnos base patientspecif data individu care plan implement within usual nurs workflow

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