Usability Testing of PROCEnf-USP: A Clinical Decision Support System.
Decision support systems (DSSs) are recognized as important tools, capable of processing high volumes of data and increasing productivity. The usability of these tools affects their effectiveness. By evaluating the interactions between registered nurses (RNs) and the DSSs, this study explores how they impact RN decision-making. This study analyzed 24 months (2011-2012) of data collected in Brazil in two units of a large, public, urban hospital in São Paulo that uses a nurse documentation system with an embedded DSS based on NANDA-I. Using mixed effects logistic regression, this study analyzed the agreement between RNs and a DSS when selecting nursing diagnoses. Results suggest that the agreement is mediated by characteristics of the RNs (education and experience) as well as units and year of encounter. Surprisingly, disagreement between RN and DSS when selecting defining characteristics (DC) had positive effects on the odds of agreement on diagnoses. Our results suggest that DSSs support nurses' clinical decision making, but the nurse's clinical judgment is the mediating factor. More research is necessary.
School of Nursing, University of Sao Paulo, Brazil.
Heloisa Helena
HH
Ciqueto Peres
School of Nursing, University of Sao Paulo, Brazil.
Diná
D
de Almeida Lopes Monteiro da Cruz
Department of Nursing and Health Sciences, California State University East Bay, USA.
Michelle
M
Tellez
School of Nursing, University of Sao Paulo, Brazil.
Rita
R
de Cassia Gengo e Silva
University Hospital, University of São Paulo, Brazil.
Diley
D
Cardoso Franco Ortiz
School of Nursing, University of Sao Paulo, Brazil.
Regina Celia
RC
dos Santos Diogo
D001938:Brazil; D020000:Decision Support Systems, Clinical / Q000706:statistics & numerical data*; D062527:Meaningful Use / Q000706:statistics & numerical data*; D009726:Nurses / Q000706:statistics & numerical data*; D009733:Nursing Diagnosis / Q000379:methods / Q000706:statistics & numerical data*; D009737:Nursing Records / Q000706:statistics & numerical data*; D014600:Utilization Review