The effect of nursing participation in the design of a critical care information system: a case study in a Chinese hospital

BMC Medical Informatics and Decision Making

Research Article

Siyu Qian¹  Ping Yu¹  Xiaodi Huang²  Qiong Wu³  Ranyun Zhou³  Jing Zheng⁴  Hua Xu⁴  Changqing Bai⁴  Xinli Chen⁴  Xun Wang⁴  Yanhong Qin⁴  Weiwei Wang⁴ 

[1] Centre for IT-enabled Transformation, School of Computing and Information Technology, University of Wollongong, 2522, Wollongong, NSW, Australia;Department of Biomedical Engineering, 307th Hospital of PLA, 100071, Beijing, China;Department of Nursing, 307th Hospital of PLA, 100071, Beijing, China;Department of Pulmonary & Critical Care Medicine, 307th Hospital of PLA, 100071, Beijing, China;

关键词: Critical care;    Intensive care;    ICU;    Information system;    Electronic health records;    EHR;    Nursing documentation;    Nurse;    Implementation;    User-centred design;    Participatory design;    Evaluation;   

DOI  :  10.1186/s12911-017-0569-3

 received in 2017-06-12, accepted in 2017-11-28,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundIntensive care information systems (ICIS) are continuously evolving to meet the ever changing information needs of intensive care units (ICUs), providing the backbone for a safe, intelligent and efficient patient care environment. Although beneficial for the international advancement in building smart environments to transform ICU services, knowledge about the contemporary development of ICIS worldwide, their usage and impacts is limited. This study aimed to fill this knowledge gap by researching the development and implementation of an ICIS in a Chinese hospital, nurses’ use of the system, and the impact of system use on critical care nursing processes and outcomes.MethodsThis descriptive case study was conducted in a 14-bed Respiratory ICU in a tertiary hospital in Beijing. Participative design was the method used for ICU nurses, hospital IT department and a software company to collaboratively research and develop the ICIS. Focus group discussions were conducted to understand the subjective perceptions of the nurses toward the ICIS. Nursing documentation time and quality were compared before and after system implementation. ICU nursing performance was extracted from the annual nursing performance data collected by the hospital.ResultsA participative design process was followed by the nurses in the ICU, the hospital IT staff and the software engineers in the company to develop and implement a highly useful ICIS. Nursing documentation was fully digitized and was significantly improved in quality and efficiency. The wrong data, missing data items and calculation errors were significantly reduced. Nurses spent more time on direct patient care after the introduction of the ICIS. The accuracy and efficiency of medication administration was also improved. The outcome was improvement in ward nursing performance as measured by ward management, routine nursing practices, disinfection and isolation, infection rate and mortality rate.ConclusionsNurses in this ICU unit in China actively participated in the ICIS development and fully used the system to document care. Introduction of the ICIS led to significant improvement in quality and efficiency in nursing documentation, medication order transcription and administration. It allowed nurses to spend more time with patients to improve quality of care. These led to improvement in overall nursing performance. Further study should investigate how the ICIS system contributes to the improvement in decision making of ICU nurses and intensivists.

【 授权许可】

CC BY   
© The Author(s). 2017