SCH: Enhancing Nurse Decision-Making via Augmented Communication Tools (ACTs)

 描述(申请人提供)：有效分析患者护理数据的智能算法可以加强临床沟通，拯救生命。2000年，医学研究所估计，美国医院每年发生9.8万例可预防的患者因沟通不畅而死亡[1]。预计电子健康记录(EHR)将促进护理团队内部的准确沟通，并提供数据以实现自动化临床决策支持系统。不幸的是，沟通不畅仍然是导致病人死亡的一个重要原因。提供者现在被要求证明有意义地使用电子病历系统来改善护理质量和患者结果。尽管如此，提供者继续报告说，电子病历系统繁琐，干扰了护理团队之间的沟通。由于检索所涉及的时间和困难，护士很少使用输入到电子病历中的信息。因此，护士继续以口头方式将危重病人护理信息传达给 轮班期间的下一位护士。口头报告或移交，在这种情况下，关键患者信息只需几分钟就能交换，效率低下。更糟糕的是，它非常容易受到通信错误的影响。更广泛的影响：研究：1)提高患者安全；2)提供初步数据，以扩大这项工作，将医生-医生和医生-RN的沟通和决策包括在电子病历中；3)分享我们的发现，告知可能也从这项技术中受益的其他行业。教育：1)帮助RN学生学习识别和有效沟通CES的策略；2)作为课程改进的一部分，包括计算机和信息科学学生的医疗保健应用程序；3)通过学术出版物、专业会议、项目网站和社交媒体传播研究结果。指导：1)指导初出茅庐的科学家，担任研究助理(RAS)和学习护理和计算机科学的博士后研究员，为正在进行的研究建立协作的跨学科关系；2)对STEM和医疗保健行业的代表性不足的学生感兴趣并招募他们。相关性(参见说明)：电子健康记录(EHR)一直被认为是最好的！以减少与沟通错误相关的患者死亡。然而，目前的EHR没有达到这一目标。我们建议开发和测试一种算法，该算法将增强EHR，以更有效地帮助护士进行决策和沟通，最终提高患者的安全性。

 DESCRIPTION (provided by applicant): Smart algorithms that effectively analyze patient care data can enhance clinical communication to save lives. In 2000, the Institute of Medicine estimated 98,000 preventable patient deaths occur annually in US hospitals due to miscommunication [1]. Electronic health records (EHRs) were expected to facilitate accurate communication within the care team and provide data to enable automated clinical decision support systems. Unfortunately, miscommunication remains a significant cause of patient deaths [2]. Providers are now required to demonstrate meaningful use of EHR systems to improve quality of care and patient outcomes. Despite this, providers continue to report that EHR systems are cumbersome and interfere with care-team communication. Information entered into an EHR is rarely used by nurses due to the time and difficulty involved in its retrieval. As a result, nurses continue to verbally convey critical patient care information to the next nurse during shift changes. Verbal report or hand-off, where critical patient information is exchanged in only minutes, is inefficient. Worse, it is highly susceptible to communication errors. Broader Impacts: Research: 1) Increase patient safety; 2) Provide preliminary data to expand this work to include physician-physician and physician-RN communication and decision-making in the EHR; 3) Share our discoveries to inform other industries who may also benefit from this technology. Education: 1) Contribute to curriculum enhancements whereby RN students learn strategies to recognize and effectively communicate CEs; 2) As part of curriculum enhancements, include healthcare applications for computer and information science students; 3) Disseminate findings via academic publications, professional meetings, a project website and social media. Mentoring: 1) Mentor budding scientists in the roles of research assistants (RAs) and post doctoral fellows studying nursing and computer science to forge collaborative interdisciplinary relationships for ongoing research; 2) Interest and recruit underrepresented students in STEM and careers in healthcare. RELEVANCE (See instructions): The electronic health record (EHR) has been thought to be a top! to decrease patient deaths related to miscommunication. However, the current EHR falls short of this goal. We propose to develop and test an algorithm that will augment the EHR to more effectively assist nurses in decision-making and communication, ultimately increasing patient safety.