Dilek YILDIRIM, Cennet ÇİRİŞ YILDIZ, Meryem BAŞIBÜYÜK

KLİNİK KARAR DESTEK SİSTEMLERİNİN HEMŞİRELİKTE KULLANIMI

Klinik karar destek sistemleri, klinisyenlere klinik karar almaya yardımcı olmak için hastaya özgü değerlendirmeler veya öneriler sunan bilgisayar ya da kâğıt temelli sistemlerdir. Günümüzde insanlar tarafından başka şekilde elde edilemeyen veya yorumlanamayan verilerden ve gözlemlerden faydalanma kabiliyetine sahip nitelikler eklenerek daha da geliştirilmiştir. Özellikle sağlıkta klinik karar destek sistemlerinin kullanımına ilişkin sınırlı kaynak olsa da örnekler, meydana gelebilecek olumsuz olayları ya da hataları azaltacağı yönündedir. Bu derlemede; hemşirelik kararlarının kanıta dayalı bilgi ile birleştirilerek uygulamada kullanımını sağlayan klinik karar destek sistemlerinin avantajları, dezavantajları, kullanım alanları ve kullanımını etkileyen faktörlerin incelenmesi amaçlanmıştır. Sağlıkta, tanılama, alarm sistemleri, hastalık yönetimi, reçete ve ilaç kontrolü gibi amaçlarla geliştirilmiş bilgisayarlı hatırlatıcılar, dokümantasyon şablonları ve klinik iş akışı araçları mevcuttur. Karar destek sistemleri hemşireler tarafından bilgilerin kaydedilmesi, hastalık seyrinin izlenmesi, bakım ile ilgili hatırlatmalarda ve daha önce alınmış olan kararların teyit edilmesi gibi çeşitli şekillerde kullanılmıştır. Yapılan araştırmalar, hemşirelerin bilgi ve deneyimi, teknoloji sisteminin özellikleri ve örgütsel faktörler gibi çeşitli faktörlerin klinik karar destek sisteminin kullanılma şeklini etkileyebileceğini göstermiştir. Klinik karar destek sistemlerinin kullanımı hemşirenin karar vermesini kolaylaştırma, tıbbi hataları ve ilaç hata sayısını azaltma, bilgiye erişimi artırma, bakım kalitesinde tutarlığın sağlanması ve özgüveni artırma gibi faydaların yanı sıra hemşirelikte kanıta dayalı uygulamayı teşvik ettiği belirlenmiştir..

Anahtar Kelimeler:

Hemşirelik, Hemşirelik Bilişimi, Klinik Karar Destek Sistemleri

The Use of Clinical Decision Support Systems in Nursing

Clinical Decision Support Systems are computer or paper based systems that provide patient-specific assessments or recommendations to help clinicians make clinical decisions. These systems, have been further developed today by adding attributes that are capable of taking advantage of data and observations that could not otherwise be obtained or interpreted by humans. In particular, although there are limited resources for the use of Clinical Decision Support Systems in healthcare, examples suggest that it will reduce negative events or errors that may occur. In this review, it is aimed to examine the Clinical Decision Support Systems’ -which enable nursing decisions to be combined with evidence-based knowledge and used in practice-; advantages, disadvantages, usage and the factors affecting the usage. In healthcare; computerized reminders, documentation templates, and clinical work-flow tools which have been developed for diagnostics, alarm systems, disease management, prescription and drug control purposes, are available. Decision support systems have been used by nurses in a variety of ways, such as recording information, monitoring the course of illness, reminders about care and confirming previously-made decisions. Researches have shown that various factors such as nurses' knowledge and experience, characteristics of the technology system and organizational factors can influence the Clinical Decision Support System’s usage way. The use of clinical decision support systems promotes evidence-based practice in nursing as well as benefits in; facilitating the decision-making of the nurse, reducing medical errors and the number of drug errors, increasing access to information, maintaining consistency in quality of care and increasing self-confidence.

Keywords:

Nursing, Nursing Informatics, Clinical Decision Support Systems,

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