】——黄安乐 卜子涵 薛梦婷 李青云 宋玉磊 柏亚妹 徐桂华
【摘要】目的 系统评价临床决策支持系统对护理实践的影响。方法 利用计算机检索中英文数据库关于临床决策支持系统影响护理实践的干预性研究，检索时限为建库至2019年9月。采用澳大利亚JBI循证卫生保健中心质量评价手册（2016）评价文献质量，运用分类归纳法提取和整合结果。结果 共纳入33篇文献，归纳出3类共9项结局指标。临床决策支持系统在护理程序、护士实践环境、批判性思维、患者安全、患者生活质量和护理服务资源等方面具有积极影响，对患者健康水平无明显作用，对经济资源和时间资源存在混合影响。结论 临床决策支持系统对护理实践和患者结局发挥积极作用，但仍存在不足，需不断完善。
【关键词】临床决策支持系统；护理实践；系统评价；护理质量
中图分类号：R47文献标识码：A
Evaluation Research on Nursing Clinical Decision Support System/HUANG Anle,BU Zihan,XUE Mengting,et al.//Chinese Health Quality Management，2021,28(1):42-45,53
Abstract Objective To systematically review the effect of clinical decision support system on nursing practice. Methods The interventional studies of clinical decision support system on nursing practice were retrieved from Chinese and English databases from establishment of the database to September 2019. The Joanna Briggs Institute's Critical Appraisal Tool (2016) was used to evaluate the quality of studies,and the results were synthesizedby classification induction.Results A total of 33 literatures were included, and a total of 9 outcome indicators were summarized in 3 categories.Clinical decision support system had a positive impact on nursing process, nurses' practice environment, critical thinking, patient safety, patient quality of life and nursing services resources. It had no significant effect on patients' health level, and had mixed impact on time resources and economic resources.Conclusion Clinical decision support system played a positive role in nursing practice and patient outcomes, but the system remained to be improved due to multiple shortcomings.
Key words Clinical Decision Support System; Nursing Practice; Systematic Review;Nursing Quality
Firstauthor's address Nanjing University of Chinese Medicine,Nanjing,Jiangsu,210023,China
随着医学模式的转变和信息技术的发展，信息化已成为护理发展的必然趋势。护理信息系统是护理信息化建设的主要内容，智能化临床决策支持系统（Clinical Decision Support System, CDSS）是护理信息化建设的新方向［1］。CDSS是通过模拟医学专家诊断和治疗疾病思维过程编制的计算机程序［2］。护理领域CDSS的开发主题主要包括辅助护理程序、智能提醒与警告、辅助健康教育以及优化护理管理等，已证实具有整合与利用数据、保障患者安全、促进护理记录标准化等优势［3］，但尚存在人机交互能力较弱、妨碍护理人员批判性思维能力发展等局限性［4］。目前，尚未有研究总结分析CDSS应用于护理领域的优势与不足。本研究基于循证医学，对国内外护理领域CDSS实践效果进行系统评价，以期为我国护理信息化建设提供借鉴。
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