지식공학을 이용한 제 2 형 당뇨질환 입원환자의 간호문제 목록 의사결정지원시스템 개발
Development of a Nursing Diagnostic Decision Support System for Inpatients with Type 2 Diabetes Mellitus Using Knowledge Engineering
0
조회
0
다운로드
0
인용
0
참고문헌
초록
Abstract
Background: The development of decision support systems for nursing has been limited by difficulties in defining and representing the nursing knowledge base and by a lack of knowledge about how nurses make decisions. However, the current trends suggest that many of the formidable technological and conceptual challenges associated with representing nursing knowledge can be overcome, and that decision support systems developed using knowledge engineering can be used to significantly improve nursing practice. Objective: The aim of this study was to develop a diagnostic nursing decision support system for inpatients with type 2 diabetes mellitus, and to elucidate the advantages and disadvantages of applying a knowledge engineering approach to its development. Methods: To acquire the relevant knowledge, a literature review was used to iteratively establish nursing diagnoses and clinical assessment criteria. Twenty-five NANDA diagnoses and 145 clinical assessment variables were structured into a criteria table used as the knowledge base for a prototype system. To investigate the responses of nurses to knowledge presentation, 27 nurses from inpatient and ambulatory settings and the graduate course of nursing informatics were recruited and a scenario-based preliminary evaluation was performed. Results: A prototype for inpatients with type 2 diabetes mellitus was developed as a Web-based stand-alone system. It automatically generated suggested nursing problem lists based on the input data, and also provided detailed explanatory information for each item on the list. We describe the advantages and disadvantages of the development approach used and discuss the users' impressions of the system. (Journal of Korean Society of Medical Informatics 12-4,305-315, 2006)
참고문헌 (32)
- F, Collins, "A vision for the future of genomics research", Nature, 422, pp.835~847 (2003)
- Institute of Medicine, "To Err is Human: building a safer Health System", pp.26~48 (2000), Washington, D.C.: National Academy Press
- JC, Wyatt, "J R Soc Med", 94(1), pp.6~9 (2001)
- M, Lavin, "A review of the use of nursing diagnosis in U.S", nurse practice acts. Nurs Diagn, 10(2), pp.57~64 (1999)
- M, Lunney, "Critical thinking and accuracy of nurses' diagnoses", Int J Nurs Terminol Classif, 14(3), pp.96~107 (2003)
- V, King, "Utilization of nursing diagnosis in three Australian hospitals", Nurs Diagn, 8(3), pp.99~109 (1997)
- K. Martin, "Nurse practitioners' use of nursing diagnosis", Nurs Diagn, 6(1), pp.9~15 (1995)
- JG, Ozbolt, "Developing decision support systems for nursing,Theoretical bases for advanced computer systems", Comput Nurs, 5(3), pp.105~111 (1987)
- P, LeMone, "Medical-surgical nursing: critical thinking in client care. 3rd ed: Pearson Education, Inc", pp.344~362 (2004)
- WJ, Phipps, "Medical-surgical nursing: concepts & clinical practice. 6th", pp.256~272 (1999), Mosby
- SC, Smeltzer, "Brunner and Suddarth's textbook of medical-surgical nursing. 8th", pp.177~190 (1996), Lippincott
- SM, Lewis, "Medical-surgical nursing: assessment and management of clinical problems. 6th", pp.284~312 (2004), Mosby
- M, Gulanick, "Nursing care plans; nursing diagnosis and intervention. 4th", pp.24~145 (1997), Mosby
- B, Kozier, "Fundamental of nursing; concepts, process, and practice. 6th", pp.55~82 (2000), Prentice-Hall Inc
- L, Carpenito-Moyet, "Nursing diagnosis; application to clinical practice. 10th", pp.1~676 (2004), Lippincott
- GK, McRarland, "Nursing diagnosis & intervention, planning for patient care. 3rd", pp.1~450 (1997), Mosby
- Diabetes Coalition of California - Private Nonprofit Organization. Basic guidelines for diabetes care. : California Diabetes Prevention and Control Program - Private Nonprofit Organization, , ~, pp.NGC:002640 (1999)
- Institute for Clinical Systems Improvement - Private Nonprofit Organization. Management of type 2 diabetes mellitus, , ~, pp.NGC:002725 (1996)
- ,. Massachusetts guidelines for adult diabetes care, "Massachusetts Department of Public Health BoFaCH", ~, pp.NGC:002655 (1999)
- United States Preventive Services Task Force - Independent Expert Panel. Screening for type 2 diabetes mellitus in adults: recommendations and rationale, , NGC:002749, ~ (1996)
- American Diabetes Association - Professional Association. Screening for type 2 diabetes, , ~, pp.NGC:003412 (2000)
- American Diabetes Association - Professional Association. Standards of medical care for patients with diabetes mellitus, , ~, pp.NGC:002793 (2002)
- International Diabetes Center - Private Nonprofit Organization. Type 2 diabetes practice guidelines, , ~, pp.NGC: 003187 (2000)
- American Diabetes Association, "Standards of medical care for patients with diabetes mellitus", Diabetes Care, 26, pp.33~ (2003)
- L, Ruqian, "New approaches to knowledge acquisition", pp.1~52 (1994), World Scientific Pub Co Inc
- K, McGraw, "Knowledge acquisition: principles and gidelines", pp.12~23 (1989), Prentice Hall
- CA, Kulikowski, "Representation of expert knowledge for consultation: the casnet and expert projects", pp.1~78 (1982), Boulder (CO): Westview Press
- D, Lindberg, "Computer-based rheumatology consultant", the Third World Conference on Medical Informatics, pp.1311~1315 (1980)
- Kingsland III LC., "The Evaluation of medical expert systems: experience with the ai", rheum knowledge-based consultant system in rheumatology, 1985, 292~295[DOI]
- IS, Cho, "Evaluation of the expressiveness of an ICNP-based nursing data dictionary in a computerized nursing record system", J Am Med Inform Assoc, 13(4), pp.456~464 (2006)
- N, Shadbolt, "From knowledge engineering to knowledge management(In British Journal of Management)", pp.309~322 (1999), Blackwell Publishing Limited
- JS, Ash, "Some unintended consequences of information technology in health care: the nature of patient care information system-related errors", J Am Med Inform Assoc, 11(2), pp.121~124 (2004)