Nurses' experiences of using a computer‐based triage decision support system in the emergency department

急诊分诊台 急诊科 医疗急救 急诊护理 决策支持系统 医学 急诊医学 护理部 计算机科学 数据挖掘
作者
Songül Bişkin Çetin,Fatma Cebeci
出处
期刊:Nursing in critical care [Wiley]
标识
DOI:10.1111/nicc.13039
摘要

Abstract Background Emergency department triage is a vital and complex decision‐making process. There is limited knowledge about nurses' experiences with triage decision support systems in emergency departments. Aim This study was conducted to examine nurses' experiences with a computer‐based triage decision support system in the emergency department. Study Design This is a qualitative and phenomenological study. Data were collected through interviews from 14 triage nurses who used a triage decision support system in the emergency department of a university hospital. The nurses were recruited for semi‐structured interviews. All interviews were recorded on a voice recorder and then transcribed. Data were analysed with the inductive content analysis method. The interviewer asked comprehensive questions about the nurses' experiences with the triage decision support system. Results Three main and 11 sub‐themes were elicited as a result of the analysis of the in‐depth interviews: (a) the facilitating the triage decision theme, which included help in case of a dilemma, team collaboration, monitoring/supervision, and error reduction sub‐themes; (b) the contribution to professionalism theme, which included ease of learning and teaching triage, professional autonomy, creating a database, and evidence‐based practice sub‐themes; (c) the areas that need improvement theme, which included reducing screen clicks, the effect of the hospital automation system performance, and clinical descriptors not included in the algorithm sub‐themes. Conclusion Triage nurses stated that the decision support system was beneficial and facilitated decision‐making. The decision support system enabled triage nurses to make their own decisions using their clinical knowledge and experience, without a restriction on their professional autonomy, and this was perceived positively. It was emphasized that this system could be a support tool in educating nurses new to triage. However, nurses stated that the pace of the decision support system was affected by the performance of the hospital automation system and that the large number of steps used for electing items caused a waste of time. They also added that these were technical areas that needed improvement. Relevance to Clinical Practice The study provides important data that will help healthcare organizations and professionals better understand the emergency department nurse triage decision support system and gain a versatile, comprehensive, and general understanding.
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