Use of Simulation to Study Nurses' Acceptance and Nonacceptance of Clinical Decision Support Suggestions.
Use of Simulation to Study Nurses' Acceptance and Nonacceptance of Clinical Decision Support Suggestions.
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使用模拟研究护士接受和不接受临床决策支持建议的情况。
DOI：
10.1097/cin.0000000000000185
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发表时间：
2015
期刊：
影响因子：
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通讯作者：
Keenan,GailM
中科院分区：
文献类型：
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作者：
Sousa,VanessaEC;Lopez,KarenDunn;Febretti,Alessandro;Stifter,Janet;Yao,Yingwei;Johnson,Andrew;Wilkie,DianaJ;Keenan,GailM
我们的长期目标是确保护士临床决策支持在临床实践中全面部署之前按预期工作。作为更广泛努力的一部分，该试点项目探讨了影响接受/不接受基于电子健康记录的护理计划护理软件原型中显示的八项临床决策支持建议的因素。由 21 名护士组成的不同样本参与了这一高保真临床模拟体验，并完成了一份调查问卷，以评估接受/不接受临床决策支持建议的原因。实验期间总共显示 168 条建议（21 名护士每人 8 条），其中 123 条（73.2%）被接受，45 条（26.8%）未被接受。护士接受的平均人数为八分之七，而 21 名护士中只有 2 人接受了全部。接受临床决策支持的主要原因是护士相信这些建议对患者有好处（100%），其他特征提供了二次强化。不接受的原因不太清楚，只有不到一半的受试者表示对证据信心不足。这项研究提供了初步证据，表明有关特定临床决策支持选择的高质量模拟和有针对性的问卷调查为在临床实践中全面部署之前提供了一种经济高效的测试手段。
Our long-term goal was to ensure nurse clinical decision support works as intended before full deployment in clinical practice. As part of a broader effort, this pilot project explored factors influencing acceptance/nonacceptance of eight clinical decision support suggestions displayed in an electronic health record–based nursing plan of care software prototype. A diverse sample of 21 nurses participated in this high-fidelity clinical simulation experience and completed a questionnaire to assess reasons for accepting/not accepting the clinical decision support suggestions. Of 168 total suggestions displayed during the experiment (eight for each of the 21 nurses), 123 (73.2%) were accepted, and 45 (26.8%) were not accepted. The mode number of acceptances by nurses was seven of eight, with only two of 21 nurses accepting all. The main reason for clinical decision support acceptance was the nurse’s belief that the suggestions were good for the patient (100%), with other features providing secondary reinforcement. Reasons for nonacceptance were less clear, with fewer than half of the subjects indicating low confidence in the evidence. This study provides preliminary evidence that high-quality simulation and targeted questionnaires about specific clinical decision support selections offer a cost-effective means for testing before full deployment in clinical practice.