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  • Title

    The Use of ICNP® in Mobile Devices (PDAs) for Nursing Documentation
  • Contact
    Grace Dal Sasso
  • Country
  • Contact Info
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  • Project Date
    2007 - 2012
  • Abstract

    Between 2007 to 2008, in the Federal University Hospital, we have developed and evaluated the mobile device computerized nursing process in critical care. This system is open source and it uses the ICNP® 1.0. Prior to this evaluation, 550 diagnoses and 660 interventions were validated. It still contains alert systems that, by the nurse's clinical evaluation, are automatically displayed in the computer screen, alerting concerning the patients that present risk potential for the development of pressure ulcers; the same nursing diagnosis from ICNP® for more than 3 days and which is this diagnosis, and if the patient are making use of vasoactive drugs such as dopamine, noradrenalin, adrenaline in doses α and ß-adrenergic. The evaluation system showed that the diagnoses of ICNP® 1.0 more identified for the nurses and that presented at least an alert system linked mainly with the evaluation cardiovascular, respiratory, tegument, neurological and renal. The study revealed that the computerized nursing process developed for the Intensive Care Unit has ergonomics and usability criteria in agreement with the established parameters for ISO 9241-11 with an average varying of Very Good (4,0) to Excellent (5,0) also guaranteeing more safety in the patients' information. There wasn´t significant difference, p > 0,05 in the evaluation among the nurses, professors and system programmers demonstrating homogeneity in the evaluation tools and in the data and clinical information. This study showed that an adverse event or its potential can be detected in real time with support of the computerized nursing process starting from the moment that the nurse proceeds the clinical evaluation and, therefore, it reinforces the importance of use of ICNP® as in the patient's safety as in intensive care. It is still important to add that the system structure is based on the work process of nurses and therefore aims to enhance and increase the presence of the nurse through the informatics. Now, we are starting the development of a data mining to figure out how the nurses are making the clinical reasoning in critical care.

    The results are:

    We established the associations of data and information that comprise the Computerized Nursing Process from ICNP, patient safety indicators and indicators quality care form AHRQ and AACCN for the expansion of alert systems in the system such as: iatrogenic pneumothorax; potential for secondary infections to the care provided; potential for wound dehiscence in postoperative patients of abdominal or pelvic surgery; potential for loss of vascular access, potential for endotracheal extubation.

    We developed a methodology for modelling and structure of computerized nursing process in intensive care.

    The measurement of time spent by nurses for carrying out the nursing process in intensive care from ICNP 1.0 was lower than mobile computerized paper (use the ICNP versin 1.0) -the evidence proved that (pValue 0.0000)

    The system has usability criteria - we concluded that Computerized Nursing Process (CNP) is a source of information and knowledge that nurses available to new modes of learning in intensive care, because it is a space that provides a broad content, complete and thorough, supported by data and research information  current and relevant scientific for nursing practice. So, the system has usability criteria (pValue 0.0000...) according to ISO/IEC 9241-11(2006) and Brazilian Association of Technical Standards.

    The measurement the cognitive workload of the completion of nursing process paper regarding the computerized nursing process(CNP) from ICNP 1.0 in ICUs showed: that the temporal demand (Pvalue=0.000) stood out as the category that most contributed to the cognitive workload in CNP category and performance  (Pvalue=0.000). It was concluded that the CNP contributed to lower cognitive workload of nurses by being a decision making support system based on the ICNP version 1.0. 

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