應用決策支援系統建構出院準備服務篩選流程之初探

吳秀玲; 黃郁珊; 莊秋萍; 周幸生

doi:10.6142/VGHN.202006_37(2).0006

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P156 - 166

医药卫生 > 预防保健与卫生学
医药卫生 > 社会医学

DOI： 10.6142/VGHN

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应用决策支援系统建构出院准备服务筛选流程之初探

Using a Clinical Decision Support System to Establish a Discharge Planning Service Flow: A Pilot Test

吴秀玲(Hsiu-Ling Wu) ；黄郁珊(Yu-Shan Huang) ；庄秋萍(Chiu-Ping Chuang) ；周幸生(Shin-Shang Chou)

荣总护理； 37 卷 2 期 (2020 / 06 / 01) ， P156 - 166

繁体中文 DOI： 10.6142/VGHN.202006_37(2).0006

出院准备服务；长期照护服务；筛选工具；临床决策支援系统； discharge planning services ； long-term care services ； assessment tool ； clinical decision support system

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摘要 │ 参考文献 (27) │ 被引用文献 (2) │ 国际计量

摘要〈TOP〉

并列摘要〈TOP〉

The number of people with disabilities has increased rapidly with Taiwan's aging society. In response, the government has increased the provision of discharge planning services as the basis for connecting to long-term care services and expanded the scope of the long-term care system. Accurate needs assessment is critical for the successful linking of these two services. The purposes of this study were to develop a discharge planning information system with a discharge planning assessment tool, adopt a clinical decision support system for linking with long-term care service resources, and test the feasibility and data consistency of the system. The study was conducted in two phases. In the first phase, the clinical experience of experts, literature reviews, and government policies were integrated to draft the discharge planning assessment tool and the rules of connecting discharge planning and long-term care service resources. The 18 clinical experts provided 26 suggestions for modification, and an information system was established based on their suggestions. This system included three major functions, namely basic patient information, assessment items, and service resource suggestions. In the second phase, content validity was enhanced through two expert focus group meetings, during which amendments were proposed to modify the system function. A total of 30 cases were selected from the system, and three long-term care case managers assessed the cases to test the interrater reliability of the items within the system. The overall Fleiss' kappa value was 0.985, which indicated that the discharge planning assessment tool featured favorable interrater reliability. The system suggested that 28 cases matched their actual discharge destinations with a consistency of 93.3%. This discharge planning assessment tool is suitable for most cases, and it is able to maintain patient individuality. The clinical nurses were assisted by the decision support of the information system, and they could perform discharge planning assessment more accurately and efficiently, which is the biggest highlight of this study.

参考文献 ( 27 ) 〈TOP〉

American Hospital Association(1983).Introduction to discharge planning for hospital.IL:American Hospital Association.
Bauer, M.,Fitzgerald, L.,Haesler, E.,Manfrin, M.(2009).Hospital discharge planning for frail older people and their family. Are we delivering best practice? A review of the evidence.Journal of Clinical Nursing,18(18),2539-2546.
Blaylock, A.,Cason, C. L.(1992).Discharge planning: Predicting patients' needs.Journal of Gerontological Nursing,18(7),5-9.
Bright, T. J.,Wong, A.,Dhurjati, R.,Bristow, E.,Bastian, L.,Coeytaux, R. R.,Musty, M. D.(2012).Effect of clinical decisionsupport systems: A systematic review.Annals of Internal Medicine,157(1),29-43.
Castaneda, C.,Nalley, K.,Mannion, C.,Bhattacharyya, P.,Blake, P.,Pecora, A.,Suh, K. S.(2015).Clinical decision support systems for improving diagnostic accuracy and achieving precision medicine.Journal of Clinical Bioinformatics,5(1),4-19.

被引用文献 ( 2 ) 〈TOP〉

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