Reasons for declining computerized insulin protocol recommendations: application of a framework.
Clinical decision support systems (CDS) can interpret detailed treatment protocols for ICU care providers. In open-loop systems, clinicians can decline protocol recommendations. We capture their reasons for declining as part of ongoing, iterative protocol validation and refinement processes. Even th...
| Publicado en: | Journal of Biomedical Informatics Vol. 41; no. 3; pp. 488 - 498 |
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| Autores principales: | , , , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Academic Press Inc.
Jun2008
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105773184&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105773184 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 15320464 OMB jtl: Journal of Biomedical Informatics issn: 15320464 maglogo: N pubinfo: dt: Jun2008 vid: 41 iid: 3 pid: 735 pub: Academic Press Inc. place: Burlington, Massachusetts artinfo: ui: 105773184 NLM18499528 2009938338 10.1016/j.jbi.2008.04.002 NLM18499528 PMC2490709 105773184 ppf: 488 ppct: 10 formats: tig: atl: Reasons for declining computerized insulin protocol recommendations: application of a framework. aug: au: Sward K Orme J Jr Sorenson D Baumann L Morris AH Sward, K Orme, J Jr Sorenson, D Baumann, L Morris, A H affil: College of Nursing, University of Utah, 10 South 2000 East, Salt Lake City, UT 84112, USA sug: subj: Attitude of Health Personnel Clinical Information Systems Decision Support Systems, Management Drug Therapy, Computer Assisted Statistics and Numerical Data Guideline Adherence Statistics and Numerical Data Insulin Administration and Dosage Professional Competence Statistics and Numerical Data Critical Care Statistics and Numerical Data Utah ab: Clinical decision support systems (CDS) can interpret detailed treatment protocols for ICU care providers. In open-loop systems, clinicians can decline protocol recommendations. We capture their reasons for declining as part of ongoing, iterative protocol validation and refinement processes. Even though our protocol was well-accepted by clinicians overall, noncompliance patterns revealed potential protocol improvement targets, and suggested ways to reduce barriers impeding software use. We applied Rita Kukafka and colleagues' (2003) IT implementation framework to identify and categorize reasons documented by ICU nurses when declining recommendations from an insulin-titration protocol. Two methods were used to operationalize the framework: reasons for declining recommendations from actual software use, and a nurse questionnaire. Applying the framework exposed limitations of our data sources, and suggested ways to address those limitations; and facilitated our analyses and interpretations. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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