Usability and Acceptability of Clinical Decision Support Based on the KIIDS-TBI Tool for Children with Mild Traumatic Brain Injuries and Intracranial Injuries.
Usability and Acceptability of Clinical Decision Support Based on the KIIDS-TBI Tool for Children with Mild Traumatic Brain Injuries and Intracranial Injuries.
复制标题
基于 KIIDS-TBI 工具的临床决策支持对于轻度创伤性脑损伤和颅内损伤儿童的可用性和可接受性。
DOI：
10.1055/s-0042-1745829
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发表时间：
2022
影响因子：
2.9
通讯作者：
Yen,Po-Yin
中科院分区：
文献类型：
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作者：
Greenberg,JacobK;Otun,Ayodamola;Kyaw,PyiTheim;Carpenter,ChristopherR;Brownson,RossC;Kuppermann,Nathan;LimbrickJr,DavidD;Foraker,RandiE;Yen,Po-Yin
儿童创伤性脑损伤决策支持工具（KIIDS-TBI）工具是一种经过验证的风险预测模型，用于管理轻度创伤性脑损伤（mTBI）和颅内损伤的儿童。电子临床决策支持（CDS）可以促进临床实施这一循证guidance. ESTA我们的目标是评估的可接受性和可用性的电子CDS工具管理儿童mTBI和颅内injuries.MethodsEmergency医学和神经外科医生（各10）来自美国10家医院的30名患者被招募参与一种新型CDS原型在模拟电子健康记录环境中的可用性测试。测试包括有声思维协议，可接受性和可用性调查，和半结构化面试。原型在测试期间更新了两次，以反映用户反馈。使用内容分析对视频中记录的可用性问题进行了分类。访谈成绩单进行了分析，使用主题analysis.ResultsAmong的20名参与者，大多数工作在教学医院（80%），独立的儿童医院（95%），和1级创伤中心（75%）。在两次原型更新期间，发现并纠正了术语清晰度和通过CDS界面导航的问题。与这些变化相对应，可用性问题的数量从第1阶段的35个减少到第3阶段的8个，错误的数量从18个（第1阶段）减少到2个（第3阶段）。通过调查，参与者发现该工具易于使用（90%），可用于确定患者的护理水平（95%），并可能改善资源使用（90%）和患者安全（79%）。访谈主题的CDS的能力，以支持循证决策和改善临床工作流程提出的实施策略和潜在的pitfuls.ConclusionAfter迭代评估和完善，KIIDS-TBI CDS工具被发现是高度可用的，并有助于帮助管理的儿童与mTBI和颅内损伤。
BackgroundThe Kids Intracranial Injury Decision Support tool for Traumatic Brain Injury (KIIDS-TBI) tool is a validated risk prediction model for managing children with mild traumatic brain injuries (mTBI) and intracranial injuries. Electronic clinical decision support (CDS) may facilitate the clinical implementation of this evidence-based guidance.ObjectiveOur objective was to evaluate the acceptability and usability of an electronic CDS tool for managing children with mTBI and intracranial injuries.MethodsEmergency medicine and neurosurgery physicians (10 each) from 10 hospitals in the United States were recruited to participate in usability testing of a novel CDS prototype in a simulated electronic health record environment. Testing included a think-aloud protocol, an acceptability and usability survey, and a semi-structured interview. The prototype was updated twice during testing to reflect user feedback. Usability problems recorded in the videos were categorized using content analysis. Interview transcripts were analyzed using thematic analysis.ResultsAmong the 20 participants, most worked at teaching hospitals (80%), freestanding children's hospitals (95%), and level-1 trauma centers (75%). During the two prototype updates, problems with clarity of terminology and navigating through the CDS interface were identified and corrected. Corresponding to these changes, the number of usability problems decreased from 35 in phase 1 to 8 in phase 3 and the number of mistakes made decreased from 18 (phase 1) to 2 (phase 3). Through the survey, participants found the tool easy to use (90%), useful for determining a patient's level of care (95%), and likely to improve resource use (90%) and patient safety (79%). Interview themes related to the CDS's ability to support evidence-based decision-making and improve clinical workflow proposed implementation strategies and potential pitfalls.ConclusionAfter iterative evaluation and refinement, the KIIDS-TBI CDS tool was found to be highly usable and useful for aiding the management of children with mTBI and intracranial injuries.