2,882 research outputs found
Nurses' use of computerised clinical decision support systems: a case site analysis
No full textAIMS AND OBJECTIVES: To explore how nurses use computerised clinical decision support systems in clinical practice and the factors that influence use.BACKGROUND: There is limited evidence for the benefits of computerised clinical decision support systems in nursing, with the majority of existing research focusing on nurses' use of decision support for telephone triage. Research has suggested that several factors including nurses' experience, features of the technology system and organisational factors may influence how decision support is used in practice.DESIGN: A multiple case site study.METHODS: Four case sites were purposively selected to provide variation in staff experience, technology used and decisions supported by the technology. Data were collected in each case site using non-participant observation of nurse/patient consultations (n = 115) and interviews with nurses (n = 55). Data were analysed using thematic content analysis.RESULTS: Computerised decision support systems were used in a variety of ways by nurses, including recording information, monitoring patients' progress and confirming decisions that had already been made. Nurses' experience with the decision and the technology affected how they used a decision support system and whether or not they over-rode recommendations made by the system. The ability of nurses to adapt the technology also affected its use.CONCLUSIONS: How nurses use computerised decision support appears to be the result of an interaction between a nurses' experience and their ability to adapt the technology to 'fit' with local clinical practice.RELEVANCE TO CLINICAL PRACTICE: One of the stated aims of introducing computerised decision support systems to assist nursing practice is to reduce variation and/or the number of errors associated with clinical practice. The study found unanticipated uses in such systems such as the routine over-riding of recommendations which could lead to an increase rather than a decrease in variation or errors.</p
A systematic review on the validity and reliability of an emergency department triage scale, the Manchester Triage System
No full textOBJECTIVE: To conduct a systematic review to check the level of validity and reliability of the Manchester Triage System and the quality of reporting of literature on this topic.DESIGN: This is a systematic review based on the PRISMA guideline on reporting systematic reviews.DATA SOURCES: The systematic search of the international literature published from 1997 through 30 November 2012 in the PubMed, Embase, Cochrane Library, Cinahl, Web of Knowledge, and Scopus databases.REVIEW METHODS: This review included quantitative and qualitative research investigating the reliability and validity of the Manchester Triage System for the broad population of adults and children visiting the emergency department. After a systematic selection process, included studies were assessed on their quality by three researchers using the STARD guidelines.RESULTS: Twelve studies were included in the review. The studies investigated the inter- and intra-rater reliability using the "kappa" statistic; the validity was tested with many measures: validity in predicting mortality, hospital admission, under- and overtriage, used resources, and length of stay in the emergency department, as well as a reference standard rating.CONCLUSIONS: In this review, the Manchester Triage System shows a wide inter-rater agreement range with a prevalence of good and very good agreement. Its safety was low because of the high rate of undertriage and the low sensitivity in predicting higher urgency levels. The high rate of overtriage could cause unnecessarily high use of resources in the emergency department. The quality of the reporting in studies of the reliability and validity of the Manchester Triage System is good.</p
Dawn, Amber
No full textcurrentMFA, BA (UBC)
Amber Dawn is the author of four books and the editor of three anthologies. Her debut novel Sub Rosa (2010) won the Lambda Literary Award for Debut Lesbian Fiction and the Writers’ Trust of Canada Dayne Ogilvie Prize. Her memoir How Poetry Saved My Life: A Hustler’s Memoir (2013) won the Vancouver Book Award. Her poetry collection Where the words end and my body begins (2015) was a finalist for BC Book Award’s Dorothy Livesay Poetry Prize. Her sophomore novel Sodom Road Exit (2018) was nominated for the Lambda Literary Award for Lesbian Fiction and the Ethel Wilson Fiction Prize
A national survey of computerised decision support systems available to nurses in England
No full textAim: to examine the characteristics of computerized decision support systems (CDSS) currently available to nurses working in the National Health Service (NHS) in England.Method: a questionnaire survey sent to a stratified random sample of 50% of all NHS care providers (Trusts) in England, asking respondents to provide information on CDSS currently used by nurses.Results: responses were received from 108 of the 277 Trusts included in the sample. Electronic patient record systems were the most common type of CDSS reported by Trusts (n = 61) but they were least likely to have features that have been associated
with improved clinical outcomes.Conclusions: the availability of CDSS with features that have been associated with improved patient outcomes for nurses in the NHS in England is limited. There is some evidence that the nature of the Trust affects whether or not nurses have access
to CDSS to assist their decision making.
Implications for nursing management The implementation of CDSS is increasing throughout the NHS. Many CDSS are introduced without adequate evidence to support its introduction and there is little evaluation of the benefits once they are
implemented. Policy makers and nursing management should consider whether the introduction of CDSS aids nurse decision making and benefits patient outcomes
Desktop – Supplemental material for How do team experience and relationships shape new divisions of labour in robot-assisted surgery? A realist investigation
No full textSupplemental material, Desktop for How do team experience and relationships shape new divisions of labour in robot-assisted surgery? A realist investigation by Rebecca Randell, Joanne Greenhalgh, Jon Hindmarsh, Stephanie Honey, Alan Pearman, Natasha Alvarado and Dawn Dowding in Health:</p
Isolation of Lipid Droplets from Cells by Density Gradient Centrifugation
No full textLipid droplets are organelles found in most mammalian cells, as well as various plant tissues and yeast. They are composed of a core of neutral lipids surrounded by a membrane monolayer of phospholipids and cholesterol into which specific proteins are embedded. This unit provides protocols for isolating lipid droplets from mammalian cells by discontinuous density gradient centrifugation
- …
