title: Nursing process decision support system for urology ward.
abstract: OBJECTIVE
  We developed a nursing process decision support system (NPDSS) based on three clinical pathways, including benign prostatic hypertrophy, inguinal hernia, and urinary tract stone. NPDSS included six major nursing diagnoses - acute pain, impaired urinary elimination, impaired skin integrity, anxiety, infection risk, and risk of falling. This paper aims to describe the design, development and validation process of the NPDSS.
  
  
  METHODS
  We deployed the Delphi method to reach consensus for decision support rules of NPDSS. A team of nine-member expert nurses from a medical center in Taiwan was involved in Delphi method. The Cronbach's α method was used for examining the reliability of the questionnaire used in the Delphi method. The Visual Basic 6.0 as front-end and Microsoft Access 2003 as back-end was used to develop the system. A team of six nursing experts was asked to evaluate the usability of the developed systems. A 5-point Likert scale questionnaire was used for the evaluation. The sensitivity and specificity of NPDSS were validated using 150 nursing chart.
  
  
  RESULTS
  The study showed a consistency between the diagnoses of the developed system (NPDSS) and the nursing charts. The sensitivities of the nursing diagnoses including acute pain, impaired urinary elimination, risk of infection, and risk of falling were 96.9%, 98.1%, 94.9%, and 89.9% respectively; and the specificities were 88%, 49.5%, 62%, and 88% respectively. We did not calculate the sensitivity and specificity of impaired skin integrity and anxiety due to non-availability of enough sample size.
  
  
  CONCLUSIONS
  NPDSS can help nurses in decision making of nursing diagnoses. Besides, it can help them to generate nursing diagnoses based on patient-specific data, individualized care plans, and implementation within their usual nursing workflow.
authors.affiliation: Department of Nursing, Chang Gung University of Science and Technology, Taiwan.
authors.forename: Angelica Te-Hui
authors.initials: AT
authors.lastname: Hao
authors.forename: Lee-Pin
authors.initials: LP
authors.lastname: Wu
authors.forename: Ajit
authors.initials: A
authors.lastname: Kumar
authors.forename: Wen-Shan
authors.initials: WS
authors.lastname: Jian
authors.forename: Li-Fang
authors.initials: LF
authors.lastname: Huang
authors.forename: Ching-Chiu
authors.initials: CC
authors.lastname: Kao
authors.forename: Chien-Yeh
authors.initials: CY
authors.lastname: Hsu
mesh_terms: D003657:Decision Making; D005260:Female; D006552:Hernia, Inguinal / Q000175:diagnosis / Q000451:nursing* / Q000628:therapy; D006801:Humans; D008297:Male; D009733:Nursing Diagnosis; D009736:Nursing Process; D018802:Patient-Centered Care / Q000592:standards; D017410:Practice Guidelines as Topic; D011470:Prostatic Hyperplasia / Q000175:diagnosis / Q000451:nursing* / Q000628:therapy; D014545:Urinary Calculi / Q000175:diagnosis / Q000451:nursing* / Q000628:therapy