Toward near real-time acuity estimation: a feasibility study.
Toward near real-time acuity estimation: a feasibility study.
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实现近实时视力估计：可行性研究。
DOI：
10.1097/01.nnr.0000280617.21189.c3
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发表时间：
2007
期刊：
影响因子：
2.5
通讯作者：
Chute,ChristopherG
中科院分区：
文献类型：
--
作者：
Kim,Hyeoneui;Harris,MarcellineR;Savova,GuerganaK;Speedie,StuartM;Chute,ChristopherG
背景：患者病情评估是护理工作量确定的基础。这是至关重要的，以估计病人的急性实时捕捉病人的护理需要更加一致和准确。Objectives：探讨使用电子护理流程中记录的病人数据在计算机化护理决策的可行性，即近实时的急性度estimation.Methods：决策算法，以确定使用流程数据的急性度指标的值开发的基础上，从经验丰富的护士决策者的输入和实施作为一个基于规则的系统（RBS）与Java专家外壳系统提供的Protégé。RBS进行了测试，随机选择的患者数据，通过比较观察到的协议与以前记录的护士'decisions.Results：观察到的协议各不相同。在9个指标中，一致率超过60%，苏格兰皇家银行倾向于在分配错误值方面达成更多一致。在研究中纳入的一致率、观察数量和数据项数量之间未观察到一致的相关性。当RBS确定的值在护士的时间范围内汇总时，协议率略有增加。协议率高于机会协议在大多数的指标包括在本study.Conclusions：两个主要因素，影响RBS的准确性指出：在源数据和决策规则的不完整性的限制。下一步是用更完整的数据集和增强的决策规则复制研究。
Background:Patient acuity estimation provides the basis of the nursing workload determination. It is critical to estimate patient acuity in real-time to capture a patient's need for nursing care more consistently and accurately.Objectives:To explore the feasibility of using patient data documented in an electronic nursing flowsheet in computerized nursing decision making; that is, near real-time acuity estimation.Methods:Decision algorithms to determine values of acuity indicators using the flowsheet data were developed based on input from experienced nurse decision-makers and implemented as a rule-based system (RBS) with the Java Expert Shell System provided in Protégé. The RBS was tested with randomly selected patient data by comparing the observed agreements with previously recorded nurses' decisions.Results:The observed agreements varied. The agreement rates exceeded 60% in nine indicators and the RBS tended to agree more on assigning false values. No consistent association was observed among the agreement rates, number of observations, and number of data items included in the study. The agreement rates increased slightly when the values determined by the RBS were aggregated following the nurses' time frame. The agreement rates were higher than chance agreement in the majority of the indicators included in this study.Conclusions:Two major factors that influenced the accuracy of the RBS were noted: limitations in source data and incompleteness of decision rules. Replicating the study with more complete data sets and enhanced decision rules was identified as the next step.