Objective: The aim of this study was to explore the experiences of nurses and physicians who use a clinical decision support system (CDSS) in the critical care area, focusing on clinicians' motives and values related to decisions to either use or not use this optional technology.
Background: Information technology (IT) has been demonstrated to positively impact quality of patient care. Decision-support technology serves as an adjunct to, not as a replacement for, actual clinical decision making. Nurse administrators play an imperative role in the planning and implementation of IT projects and can benefit from understanding clinicians' affective considerations and approaches to the technology.
Methods: This qualitative study used grounded theory methods. A total of 33 clinicians participated in in-depth structured interviews probing their professional concerns with how the technology is used. Data were analyzed using the constant comparative method.
Results: Medical staff were frustrated by perceived lack of planning input before system implementation. Both nurse and physician cohort groups were dissatisfied with preimplementation education. Barriers to system use were identified in significant detail by the participants.
Conclusion: Both nurses and physicians should be involved in preimplementation planning and ongoing evaluation of CDSSs. There is a need for a systematic review or Cochrane meta-analysis describing the affective aspects of successful implementations of decisional technology in critical care, specifically from the perspective of nursing administrators.
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http://dx.doi.org/10.1097/NNA.0b013e3181bd5fc2 | DOI Listing |
Pediatr Surg Int
December 2024
Pediatric Surgery Department, Hospital Universitari i Politècnic La Fe, Av/Fernando Abril Martorell 106, 46026, Valencia, Spain.
Purpose: To assess the diagnostic performance of hemoglobin concentration for Meckel's diverticulum (MD) and evaluate if hemoglobin levels could be useful in the surgical decision-making process of children with lower gastrointestinal bleeding (LGIB).
Methods: Retrospective cohort study of children with LGIB attending the emergency department between 2011 and 2021. Episodes of LGIB were divided into two groups: MeckD (MD diagnosed by surgery) and non-MeckD.
Disabil Rehabil
December 2024
Margalla Institute of Health Sciences, Rawalpindi, Pakistan.
Purpose: To linguistically and cross-culturally translate Hip Disability and Osteoarthritis Outcome Score into Urdu language (HOOS-U), and test its psychometric properties among patients with hip pain.
Materials And Methods: Translation and cross-cultural adaptation of English version of HOOS were carried out following international guidelines. Psychometric testing included reliability (internal consistency and test-retest reliability), validity (content and construct validity) and responsiveness.
J Am Med Inform Assoc
December 2024
AI for Health Institute, Washington University in St Louis, St Louis, MO 63130, United States.
Objective: Early detection of surgical complications allows for timely therapy and proactive risk mitigation. Machine learning (ML) can be leveraged to identify and predict patient risks for postoperative complications. We developed and validated the effectiveness of predicting postoperative complications using a novel surgical Variational Autoencoder (surgVAE) that uncovers intrinsic patterns via cross-task and cross-cohort presentation learning.
View Article and Find Full Text PDFBiometrics
October 2024
RAND Corporation, Pittsburgh, PA 15213, United States.
Health care decisions are increasingly informed by clinical decision support algorithms, but these algorithms may perpetuate or increase racial and ethnic disparities in access to and quality of health care. Further complicating the problem, clinical data often have missing or poor quality racial and ethnic information, which can lead to misleading assessments of algorithmic bias. We present novel statistical methods that allow for the use of probabilities of racial/ethnic group membership in assessments of algorithm performance and quantify the statistical bias that results from error in these imputed group probabilities.
View Article and Find Full Text PDFAnn Med
December 2025
Department of General Surgery, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou School of Clinical Medicine, Nanjing Medical University, Taizhou, China.
Objective: To comprehensively investigate the predictive value of thyroid hormone sensitivity parameters for cervical lymph node metastasis in patients diagnosed with differentiated thyroid cancer (DTC) undergoing total thyroidectomy and neck lymph node dissection.
Methods: A retrospective cohort study was conducted involving patients diagnosed with DTC and evaluated for cervical lymph node metastasis. Relevant demographic, tumour, lymph node and thyroid hormone sensitivity parameter data were extracted from medical records and laboratory reports.
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