Int J Med Inform - Effects of a computerized decision support system on pressure ulcers and malnutrition in nursing homes for the elderly.

Tópicos

{ care(1570) inform(1187) nurs(1089) }
{ intervent(3218) particip(2042) group(1664) }
{ assess(1506) score(1403) qualiti(1306) }
{ ehr(2073) health(1662) electron(1139) }
{ sampl(1606) size(1419) use(1276) }
{ patient(1821) servic(1111) care(1106) }
{ decis(3086) make(1611) patient(1517) }
{ risk(3053) factor(974) diseas(938) }
{ time(1939) patient(1703) rate(768) }
{ patient(2315) diseas(1263) diabet(1191) }
{ general(901) number(790) one(736) }
{ perform(999) metric(946) measur(919) }
{ research(1218) medic(880) student(794) }
{ analysi(2126) use(1163) compon(1037) }
{ method(2212) result(1239) propos(1039) }
{ clinic(1479) use(1117) guidelin(835) }
{ search(2224) databas(1162) retriev(909) }
{ blood(1257) pressur(1144) flow(957) }
{ cancer(2502) breast(956) screen(824) }
{ use(1733) differ(960) four(931) }
{ studi(1119) effect(1106) posit(819) }
{ age(1611) year(1155) adult(843) }
{ data(3008) multipl(1320) sourc(1022) }
{ activ(1138) subject(705) human(624) }
{ inform(2794) health(2639) internet(1427) }
{ surgeri(1148) surgic(1085) robot(1054) }
{ framework(1458) process(801) describ(734) }
{ design(1359) user(1324) use(1319) }
{ control(1307) perform(991) simul(935) }
{ data(3963) clinic(1234) research(1004) }
{ research(1085) discuss(1038) issu(1018) }
{ perform(1367) use(1326) method(1137) }
{ spatial(1525) area(1432) region(1030) }
{ medic(1828) order(1363) alert(1069) }
{ signal(2180) analysi(812) frequenc(800) }
{ cost(1906) reduc(1198) effect(832) }
{ group(2977) signific(1463) compar(1072) }
{ use(2086) technolog(871) perceiv(783) }
{ drug(1928) target(777) effect(648) }
{ estim(2440) model(1874) function(577) }
{ model(3404) distribut(989) bayesian(671) }
{ can(774) often(719) complex(702) }
{ imag(1947) propos(1133) code(1026) }
{ data(1737) use(1416) pattern(1282) }
{ system(1976) rule(880) can(841) }
{ measur(2081) correl(1212) valu(896) }
{ imag(1057) registr(996) error(939) }
{ bind(1733) structur(1185) ligand(1036) }
{ sequenc(1873) structur(1644) protein(1328) }
{ method(1219) similar(1157) match(930) }
{ featur(3375) classif(2383) classifi(1994) }
{ imag(2830) propos(1344) filter(1198) }
{ network(2748) neural(1063) input(814) }
{ imag(2675) segment(2577) method(1081) }
{ take(945) account(800) differ(722) }
{ studi(2440) review(1878) systemat(933) }
{ motion(1329) object(1292) video(1091) }
{ treatment(1704) effect(941) patient(846) }
{ problem(2511) optim(1539) algorithm(950) }
{ error(1145) method(1030) estim(1020) }
{ chang(1828) time(1643) increas(1301) }
{ learn(2355) train(1041) set(1003) }
{ concept(1167) ontolog(924) domain(897) }
{ algorithm(1844) comput(1787) effici(935) }
{ extract(1171) text(1153) clinic(932) }
{ method(1557) propos(1049) approach(1037) }
{ data(1714) softwar(1251) tool(1186) }
{ model(2220) cell(1177) simul(1124) }
{ method(984) reconstruct(947) comput(926) }
{ featur(1941) imag(1645) propos(1176) }
{ case(1353) use(1143) diagnosi(1136) }
{ howev(809) still(633) remain(590) }
{ studi(1410) differ(1259) use(1210) }
{ system(1050) medic(1026) inform(1018) }
{ import(1318) role(1303) understand(862) }
{ model(2341) predict(2261) use(1141) }
{ visual(1396) interact(850) tool(830) }
{ compound(1573) activ(1297) structur(1058) }
{ record(1888) medic(1808) patient(1693) }
{ health(3367) inform(1360) care(1135) }
{ model(3480) simul(1196) paramet(876) }
{ monitor(1329) mobil(1314) devic(1160) }
{ state(1844) use(1261) util(961) }
{ patient(2837) hospit(1953) medic(668) }
{ model(2656) set(1616) predict(1553) }
{ data(2317) use(1299) case(1017) }
{ gene(2352) biolog(1181) express(1162) }
{ first(2504) two(1366) second(1323) }
{ can(981) present(881) function(850) }
{ health(1844) social(1437) communiti(874) }
{ structur(1116) can(940) graph(676) }
{ high(1669) rate(1365) level(1280) }
{ use(976) code(926) identifi(902) }
{ result(1111) use(1088) new(759) }
{ implement(1333) system(1263) develop(1122) }
{ survey(1388) particip(1329) question(1065) }
{ process(1125) use(805) approach(778) }
{ activ(1452) weight(1219) physic(1104) }
{ method(1969) cluster(1462) data(1082) }
{ detect(2391) sensit(1101) algorithm(908) }

Resumo

CKGROUND: Computerized decision support systems (CDSSs) have been shown to help health care professionals to avoid errors and improve clinical practice and efficiency in health care. Little is known about its influence on nursing practice and outcomes for residents in nursing homes.AIM: The aim of this study was to evaluate the effects on the risk for and prevalence of pressure ulcers (PUs) and malnutrition of implementing a CDSS to improve prevention and care of PUs and also to improve nutrition in the elderly in nursing homes.DESIGN SETTING AND PARTICIPANTS: The study used a quasi-experimental design with two intervention groups and one control group. A convenience sample of residents from 46 units in 15 nursing homes in rural areas in Norway was included. A total of 491 residents participated at baseline in 2007 and 480 residents at follow-up in 2009.METHODS: The intervention included educational sessions in prevention of PUs and malnutrition for registered nurses (RNs) and nursing aides (NAs) in the two intervention groups. In addition, one intervention group (intervention group 1) had a CDSS integrated into the electronic healthcare record (EHR) based on two research-based risk assessment instruments: the Risk Assessment Pressure Scale (RAPS) for PU risk screening and the Mini Nutritional Assessment (MNA(?)) scale for screening nutritional status. In each participating nursing home trained RNs and NAs examined all residents who consented to participate on the RAPS and the MNA(?) scale. This examination included a skin assessment and details about PUs were collected.RESULTS: The proportion of malnourished residents decreased significantly in intervention group 1 between the two data collection periods (2007 and 2009). No other significant effects of the CDSS on resident outcomes based on the RAPS and MNA(?) scores were found.CONCLUSION: CDSSs used by RNs and NAs in nursing homes are still largely unexplored. A CDSS can be incorporated into the EHR to increase the meaningful use of these computerized systems in nursing home care. The effects of CDSS on healthcare provider workflow, clinical decision making and communication about preventive measures in nursing home practice still need further exploration. Based on results from our study, recommendations would be to increase both sample size and the number of RNs and NAs who participate in CDSS education programs.

Resumo Limpo

ckground computer decis support system cdsss shown help health care profession avoid error improv clinic practic effici health care littl known influenc nurs practic outcom resid nurs homesaim aim studi evalu effect risk preval pressur ulcer pus malnutrit implement cdss improv prevent care pus also improv nutrit elder nurs homesdesign set particip studi use quasiexperiment design two intervent group one control group conveni sampl resid unit nurs home rural area norway includ total resid particip baselin resid followup method intervent includ educ session prevent pus malnutrit regist nurs rns nurs aid nas two intervent group addit one intervent group intervent group cdss integr electron healthcar record ehr base two researchbas risk assess instrument risk assess pressur scale rap pu risk screen mini nutrit assess mna scale screen nutrit status particip nurs home train rns nas examin resid consent particip rap mna scale examin includ skin assess detail pus collectedresult proport malnourish resid decreas signific intervent group two data collect period signific effect cdss resid outcom base rap mna score foundconclus cdsss use rns nas nurs home still larg unexplor cdss can incorpor ehr increas meaning use computer system nurs home care effect cdss healthcar provid workflow clinic decis make communic prevent measur nurs home practic still need explor base result studi recommend increas sampl size number rns nas particip cdss educ program

Resumos Similares

Int J Med Inform - Effects of a computerized decision support system on care planning for pressure ulcers and malnutrition in nursing homes: an intervention study. ( 0,850826550809879 )
Int J Med Inform - Health information exchange interventions can enhance quality and continuity of HIV care. ( 0,779227639877245 )
J Telemed Telecare - The benefits of e-health support for older family caregivers in rural areas. ( 0,779148864467679 )
Telemed J E Health - Telehealth group interactions in the hospice setting: assessing technical quality across platforms. ( 0,776720532405273 )
J Am Med Inform Assoc - The intended and unintended consequences of communication systems on general internal medicine inpatient care delivery: a prospective observational case study of five teaching hospitals. ( 0,762195299853847 )
Appl Clin Inform - Advice for Decision Makers Based on an Electronic Health Record Evaluation at a Program for All-inclusive Care for Elders Site. ( 0,745101790969055 )
Telemed J E Health - TEAhM-Technologies for Enhancing Access to Health Management: a pilot study of community-based telehealth. ( 0,734688713212052 )
J. Med. Internet Res. - Cost-effectiveness and cost-utility of Internet-based computer tailoring for smoking cessation. ( 0,717131474103586 )
J. Med. Internet Res. - Supporting self-care for families of children with eczema with a Web-based intervention plus health care professional support: pilot randomized controlled trial. ( 0,712897617795136 )
J. Med. Internet Res. - Changes in depressive symptoms, social support, and loneliness over 1 year after a minimum 3-month videoconference program for older nursing home residents. ( 0,710056007378148 )
AMIA Annu Symp Proc - Coordination of care for complex pediatric patients: perspectives from providers and parents. ( 0,709832404588921 )
Inform Health Soc Care - Experiences with using information and communication technology to build a multi-municipal support network for informal carers. ( 0,709036769418047 )
AMIA Annu Symp Proc - A mixed methods approach for measuring the impact of delivery-centric interventions on clinician workflow. ( 0,708865156298334 )
AMIA Annu Symp Proc - Examining the Multi-level Fit between Work and Technology in a Secure Messaging Implementation. ( 0,706790883042922 )
Telemed J E Health - Analysis of the impact of the Birmingham OwnHealth program on secondary care utilization and cost: a retrospective cohort study. ( 0,699016622053476 )
Telemed J E Health - Examining perceptions of a smartphone-based intervention system for alcohol use disorders. ( 0,697285268269495 )
AMIA Annu Symp Proc - A software communication tool for the tele-ICU. ( 0,697271473697574 )
BMC Med Inform Decis Mak - Impact of a chronic kidney disease registry and provider education on guideline adherence--a cluster randomized controlled trial. ( 0,697010015367914 )
J. Med. Internet Res. - An evaluation of the use of smartphones to communicate between clinicians: a mixed-methods study. ( 0,695732581313535 )
Telemed J E Health - Implementing home blood glucose and blood pressure telemonitoring in primary care practices for patients with diabetes: lessons learned. ( 0,695113448985256 )
J Telemed Telecare - Perception, satisfaction and utilization of the VALUE home telehealth service. ( 0,692129688828705 )
J. Med. Internet Res. - Perceived barriers and facilitators of using a Web-based interactive decision aid for colorectal cancer screening in community practice settings: findings from focus groups with primary care clinicians and medical office staff. ( 0,691037798037929 )
Int J Med Inform - Multi-disciplinary communication networks for skin risk assessment in nursing homes with high IT sophistication. ( 0,690868738048912 )
Telemed J E Health - Can an evidence-based book club intervention delivered via a tablet computer improve physical activity in middle-aged women? ( 0,688172097583228 )
J. Med. Internet Res. - Exploring patients' views of a cognitive behavioral therapy-based website for the self-management of irritable bowel syndrome symptoms. ( 0,687826287462341 )
Inform Health Soc Care - Information practices of health care professionals related to patient discharge from hospital. ( 0,685480912763732 )
J. Med. Internet Res. - Web-based intervention in mindfulness meditation for reducing residual depressive symptoms and relapse prophylaxis: a qualitative study. ( 0,682222080287255 )
J. Med. Internet Res. - Internal versus external motivation in referral of primary care patients with depression to an internet support group: randomized controlled trial. ( 0,681547776828816 )
BMC Med Inform Decis Mak - Qualitative evaluation of a diabetes electronic decision support tool: views of users. ( 0,678784093728767 )
Telemed J E Health - A telehealth strategy for increasing adherence in the treatment of hypertension in primary care. ( 0,678700615968278 )
Appl Clin Inform - CAH to CAH: EHR implementation advice to critical access hospitals from peer experts and other key informants. ( 0,677792100494392 )
Appl Clin Inform - Novel computerized health risk appraisal may improve longitudinal health and wellness in primary care: a pilot study. ( 0,677678360268539 )
Int J Med Inform - Exploring practice variation in preventive pressure-ulcer care using data from a clinical data repository. ( 0,675040433998012 )
Int J Med Inform - The benefits of introducing electronic health records in residential aged care facilities: a multiple case study. ( 0,666068281513276 )
Inform Health Soc Care - Patients' contribution to the development of a web-based plan for integrated care - a participatory design study. ( 0,665719405509773 )
BMC Med Inform Decis Mak - National survey focusing on the crucial information needs of intensive care charge nurses and intensivists: same goal, different demands. ( 0,66421339196407 )
BMC Med Inform Decis Mak - From design to implementation--the Joint Asia Diabetes Evaluation (JADE) program: a descriptive report of an electronic web-based diabetes management program. ( 0,663698683039626 )
J Am Med Inform Assoc - Patient portal doldrums: does an exam room promotional video during an office visit increase patient portal registrations and portal use? ( 0,663075735030744 )
Int J Med Inform - Using Cognitive Work Analysis to fit decision support tools to nurse managers' work flow. ( 0,662288793952135 )
J. Med. Internet Res. - Overcoming Addictions, a Web-based application, and SMART Recovery, an online and in-person mutual help group for problem drinkers, part 1: three-month outcomes of a randomized controlled trial. ( 0,661186390919269 )
Int J Med Inform - Evaluation of a comprehensive EHR based on the DeLone and McLean model for IS success: approach, results, and success factors. ( 0,660593231139416 )
J Telemed Telecare - Automated home telephone self-monitoring reduces hospitalization in patients with advanced heart failure. ( 0,65962371536025 )
Telemed J E Health - Task-technology fit of video telehealth for nurses in an outpatient clinic setting. ( 0,659387821645298 )
Healthc (Amst) - When scaling prevention means scaling demand: Voluntary medical male circumcision in Nyanza Province, Kenya. ( 0,658683946846034 )
Int J Med Inform - A model of awareness to enhance our understanding of interprofessional collaborative care delivery and health information system design to support it. ( 0,656494220935517 )
BMC Med Inform Decis Mak - Communicating cancer treatment information using the Web: utilizing the patient's perspective in website development. ( 0,656053841897386 )
J. Med. Internet Res. - Effectiveness of Web-based versus face-to-face delivery of education in prescription of falls-prevention exercise to health professionals: randomized trial. ( 0,655059301845595 )
Healthc (Amst) - The EFECT framework for interprofessional education in the patient centered medical home. ( 0,653849351442519 )
AMIA Annu Symp Proc - Describing the Clinical Communication Space through a Model of Common Ground: 'you don't know what you don't know'. ( 0,653296890131115 )
J Telemed Telecare - A pilot study of the effectiveness of home teleconsultations in paediatric palliative care. ( 0,651857093509786 )
J Am Med Inform Assoc - Impact of a clinical decision support system on antibiotic prescribing for acute respiratory infections in primary care: quasi-experimental trial. ( 0,650044072021424 )
Telemed J E Health - Patient-clinician mobile communication: analyzing text messaging between adolescents with asthma and nurse case managers. ( 0,648631731067333 )
J Am Med Inform Assoc - The impact of PACS on clinician work practices in the intensive care unit: a systematic review of the literature. ( 0,648263430633809 )
BMC Med Inform Decis Mak - A qualitative evaluation of general practitioners' views on protocol-driven eReferral in Scotland. ( 0,64793027128655 )
Appl Clin Inform - Understanding interprofessional communication: a content analysis of email communications between doctors and nurses. ( 0,647288516523238 )
AMIA Annu Symp Proc - Falling through the cracks: information breakdowns in critical care handoff communication. ( 0,645843225139027 )
Healthc (Amst) - Association of medical home team-based care functions and perceived improvements in patient-centered care at VHA primary care clinics. ( 0,645667808692722 )
BMC Med Inform Decis Mak - Participatory eHealth development to support nurses in antimicrobial stewardship. ( 0,645358079259412 )
Appl Clin Inform - Registers for Networked Medical Research in Germany: Situation and prospects. ( 0,645082912015635 )
J Innov Health Inform - Using information to deliver safer care: a mixed-methods study exploring general practitioners' information needs in North West London primary care. ( 0,644974943387746 )
Int J Med Inform - Managing variations from surgical care plans: challenges for coordination. ( 0,644678803417698 )
BMC Med Inform Decis Mak - The role of ICT in supporting disruptive innovation: a multi-site qualitative study of nurse practitioners in emergency departments. ( 0,643479924742608 )
J. Med. Internet Res. - Leveraging text messaging and mobile technology to support pediatric obesity-related behavior change: a qualitative study using parent focus groups and interviews. ( 0,641661567489179 )
Comput. Biol. Med. - Smart medical environment at the point of care: auto-tracking clinical interventions at the bed side using RFID technology. ( 0,641123933711341 )
Telemed J E Health - Outcomes of a home telehealth intervention for patients with diabetes and hypertension. ( 0,639828770030345 )
Telemed J E Health - The practice of telehealth by nurses: an experience in primary healthcare in Brazil. ( 0,638344424878377 )
Int J Med Inform - Evaluation of the national nursing model and four nursing documentation systems in Finland--lessons learned and directions for the future. ( 0,638098264149273 )
Int J Med Inform - Use of electronic information systems in nursing management. ( 0,636328096221364 )
BMC Med Inform Decis Mak - Successful implementation of new technologies in nursing care: a questionnaire survey of nurse-users. ( 0,635127116554841 )
Telemed J E Health - Home telehealth: facilitators, barriers, and impact of nurse support among high-risk dialysis patients. ( 0,634738323553319 )
J. Med. Internet Res. - Effects of an individually tailored Web-based chronic pain management program on pain severity, psychological health, and functioning. ( 0,633039842530528 )
J Telemed Telecare - A randomised controlled trial of providing personalised cardiovascular risk information to modify health behaviour. ( 0,632861713976606 )
Int J Med Inform - The impact of medical record technologies on collaboration in emergency medicine. ( 0,632679569511977 )
Int J Med Inform - Adoption of a clinical decision support system to promote judicious use of antibiotics for acute respiratory infections in primary care. ( 0,632588310487285 )
Healthc (Amst) - Flexible implementation and integration of new team members to support patient-centered care. ( 0,63191696039163 )
J Am Med Inform Assoc - Impact of an electronic medication management system on hospital doctors' and nurses' work: a controlled pre-post, time and motion study. ( 0,631910217210816 )
BMC Med Inform Decis Mak - Quality of prenatal and maternal care: bridging the know-do gap (QUALMAT study): an electronic clinical decision support system for rural Sub-Saharan Africa. ( 0,631365405875396 )
J. Med. Internet Res. - Effectiveness of different Web-based interventions to prepare co-smokers of cigarettes and cannabis for double cessation: a three-arm randomized controlled trial. ( 0,630123007808451 )
J Med Syst - How are health professionals using health information exchange systems? Measuring usage for evaluation and system improvement. ( 0,627656639210149 )
J Biomed Inform - Informing the design of clinical decision support services for evaluation of children with minor blunt head trauma in the emergency department: a sociotechnical analysis. ( 0,626689258400462 )
Int J Med Inform - Does an integrated Emergency Department Information System change the sequence of clinical work? A mixed-method cross-site study. ( 0,625971528610415 )
J Telemed Telecare - Telehealth in palliative care in the UK: a review of the evidence. ( 0,625593222457439 )
Int J Med Inform - Going paperless at the emergency department: a socio-technical study of an information system for patient tracking. ( 0,6248224059737 )
Int J Med Inform - Guidelines for maternal and neonatal point of care: needs of and attitudes towards a computerized clinical decision support system in rural Burkina Faso. ( 0,623704015263872 )
J Am Med Inform Assoc - Intensive care unit nurses' information needs and recommendations for integrated displays to improve nurses' situation awareness. ( 0,623580931533822 )
J. Med. Internet Res. - Evaluation of a Web-based intervention to promote hand hygiene: exploratory randomized controlled trial. ( 0,623084513055629 )
J. Med. Internet Res. - The effects of combining Web-based eHealth with telephone nurse case management for pediatric asthma control: a randomized controlled trial. ( 0,622276516542062 )
Int J Med Inform - Effect of a nursing information system on the quality of information processing in nursing: An evaluation study using the HIS-monitor instrument. ( 0,620859497492569 )
Telemed J E Health - Communication strategies and timeliness of response to life critical telemetry alarms. ( 0,62067063043 )
J. Med. Internet Res. - Adherence to a smartphone application for weight loss compared to website and paper diary: pilot randomized controlled trial. ( 0,620518791375642 )
Health Info Libr J - Health education for Somali Bantu refugees via home visits. ( 0,620242235021125 )
AMIA Annu Symp Proc - Development of a nursing handoff tool: a web-based application to enhance patient safety. ( 0,620046114912919 )
BMC Med Inform Decis Mak - Designing a multifaceted survivorship care plan to meet the information and communication needs of breast cancer patients and their family physicians: results of a qualitative pilot study. ( 0,619989590385624 )
J. Med. Internet Res. - A web-based program improves physical activity outcomes in a primary care angina population: randomized controlled trial. ( 0,619626179832341 )
J. Med. Internet Res. - Improving adherence to antiretroviral therapy for youth living with HIV/AIDS: a pilot study using personalized, interactive, daily text message reminders. ( 0,619552552697165 )
J Biomed Inform - Bridging gaps in handoffs: a continuity of care based approach. ( 0,618953429747843 )
Telemed J E Health - Telephonic monitoring and optimization of inhaler technique. ( 0,616787245376887 )
Med Decis Making - Participation of very old adults in health care decisions. ( 0,616260652917128 )
J. Med. Internet Res. - Experiences of multidisciplinary development team members during user-centered design of telecare products and services: a qualitative study. ( 0,616013947392393 )
J Med Syst - EHR implementation in a new clinic: a case study of clinician perceptions. ( 0,615515818494023 )