护理信息化在重症患者中的应用进展

doi:10.16460/j.issn1008-9969.2024.14.047

摘要/Abstract

摘要： 目的综述国内外护理信息化在重症患者中的应用与发展现状,以及我国在重症患者护理信息化存在的问题,为ICU护理信息化发展提供借鉴。方法检索国内外相关文献,从ICU护理信息化内容、远程护理、AI护理及ICU护理信息化教育简述国内外ICU护理信息化发展现状,总结当前重症患者护理信息化面临的问题,并提出思考与建议。结果国外关于ICU护理信息化建设优于且早于国内,AI技术发展早且相对成熟;国外着重关注于发展护理人员的信息学能力,制定了完善的人才培训计划,以培养多学科人才,为重症护理学发展提供强有力工具。目前,我国的信息化多集中于预警系统、电子化记录单、AI预测模型及综述等研究,对于人才培养以及学科建设尚处于构建阶段。结论我国ICU护理信息化技术还处于初步探索阶段,人才教育、培训及管理模式尚处于起步阶段,应广泛汲取国外优秀信息化建设及培训方案,以促进护理信息化发展。有待借鉴国外经验,推动护理信息学教育体系建设,完善重症护理信息化管理相关法律法规及相关标准。此外,各级政府、地方医疗卫生机构建立适应相关政策,以三方协作模式促进重症护理信息化发展。

中图分类号:

R47-05

于尚平, 李飞, 刘颖, 吴辉. 护理信息化在重症患者中的应用进展[J]. 护理学报, 2024, 31(14): 47-51.

参考文献

[1] 中华人民共和国中央人民政府.国家卫生健康委关于印发《全国护理事业发展规划(2021-2025年)》的通知[EB/OL].(2023-06-15).https://www.gov.cn/zhengce/zhengceku/2022-05/09/content_5689354.htm.
[2] Choi J, Bakken S.Validation of the Self-assessment of Nursing Informatics Competencies Scale among undergraduate and graduate nursing students[J]. J Nurs Educ,2013,52(5):275-282. DOI:10.3928/01484834-20130412-01.
[3] Fung KYM.Utilizing TIGER competencies to improve informatics practice[D]. San Francisco: the University of San Francisco,2016.
[4] Collins S, Couture B, Kang MJ, et al.Quantifying and visualizing nursing flowsheet documentation burden in acute and critical care[J]. AMIA Annu Symp Proc, 2018, 12(5):348-357.
[5] De Georgia MA, Kaffashi F, Jacono FJ, et al.Information technology in critical care: review of monitoring and data acquisition systems for patient care and research[J]. SCI World,2015,2015:727694. DOI:10.1155/2015/727694.
[6] Hardiker NR, Dowding D, Dykes PC, et al.Reinterpreting the nursing record for an electronic context[J].Int J Med Inform,2019,127:120-126. DOI:10.1016/j.ijmedinf.2019.04.021.
[7] Piscotty RJ Jr, Kalisch B.The relationship between electronic nursing care reminders and missed nursing care[J]. Comput Inform Nurs, 2014, 32(10):475-481. DOI:10.1097/CIN.0000000000000092.
[8] Piscotty RJ, Kalisch B, Gracey-Thomas A, et al.Electronic nursing care reminders:implications for nursing leaders[J]. J Nurs Adm, 2015, 45(5):239-242.DOI:10.1097/NNA.0000000000000192.
[9] Tataei A, Rahimi B, Afshar HL, et al.The effects of electronic nursing handover on patient safety in the general (non-COVID-19) and COVID-19 intensive care units: a quasi-experimental study[J]. BMC Health Serv Res,2023,23(1):527.DOI: 10.1186/s12913-023-09502-8.
[10] Almeida SR, Sasso GT, Barra DC.Computerized nursing process in the Intensive Care Unit: ergonomics and usability[J].Rev Esc Enferm USP,2016,50(6):998-1004.DOI: 10.1590/S0080-623420160000700017.
[11] Pachchigar R, Blackwell N, Webb L, et al.Development and implementation of a clinical information system-based protocol to improve nurse satisfaction of end-of-life care in a single intensive care unit[J]. Aust Crit Care, 2022,35(3):273-278. DOI: 10.1016/j.aucc.2021.05.003.
[12] Udeh C, Udeh B, Canfield C, et al.Telemedicine/virtual ICU: where are we and where are we going?[J].Methodist Debakey Cardiovasc J, 2018,14(2):126-133.DOI:10.14797/mdcj-14-2-126.
[13] Robert N.How artificial intelligence is changing nursing[J].Nurs Manage,2019,50(9):30-39. DOI: 10.1097/01.NUMA.0000578988.56622.21.
[14] Ng ZQP, Ling LYJ, Chew HSJ, et al.The role of artificial intelligence in enhancing clinical nursing care:a scoping review[J]. J Nurs Manag, 2023,30(8):3654-3674.DOI:10.1111/jonm.13425.
[15] Galatzan BJ, Carrington JM, Gephart S.Testing the use of Natural Language Processing Software and Content Analysis to analyze nursing hand-off text data[J].Comput Inform Nurs,2021,39(8):411-417.DOI:10.1097/CIN.0000000000000732.
[16] Aickelin U,Burke EK,Li J.An estimation of distribution algorithm with intelligent local search for rule-based nurse rostering[J].J Oper Res Soc,2007,58(12):1574-1585.DOI:10.1057/palgrave.jors.2602308.
[17] King CR, Shambe A, Abraham J. Potential uses of AI for perioperative nursing handoffs: a qualitative study[J]. JAMIA Open,2023,6(1):ooad015.DOI:10.1093/jamiaopen/ooad015.
[18] Majima Y, Izumi T.Long-term changes of information environments and computer anxiety of nurse administrators in Japan[J]. Stud Health Technol Inform,2013,192:1047.DOI:10.3233/978-1-61499-289-9-1047.
[19] Bickford CJ.The Professional Association's Perspective on nursing informatics and competencies in the US[J]. Stud Health Technol Inform,2017,232:62-68.DOI:10.3233/978-1-61499-738-2-62.
[20] Kleib M, Chauvette A, Furlong K, et al.Approaches for defining and assessing nursing informatics competencies: a scoping review[J]. JBI Evid Synth,2021,19(4):794-841. DOI: 10.11124/JBIES-20-00100.
[21] Lindroth HL, Pinevich Y,Barwise AK, et al.Information and data visualization needs among direct care nurses in the Intensive Care Unit[J]. Appl Clin Inform, 2022, 13(5):1207-1213. DOI:10.1055/s-0042-1758735.
[22] Lavin MA, Harper E, Barr N.Health information technology, patient safety, and professional nursing care documentation in acute care settings[J]. 2015,20(2):6.DOI:10.3912/OJIN.Vol20No02PPT04.
[23] Jouparinejad S, Foroughameri G, Khajouei R, et al.Improving the informatics competency of critical care nurses: results of an interventional study in the southeast of Iran[J]. BMC Med Inform Decis Mak,2020,20(1):220.DOI:10.1186/s12911-020-01244-5.
[24] Farokhzadian J, Jouparinejad S, Fatehi F, et al.Improving nurses' readiness for evidence-based practice in critical care units: results of an information literacy training program[J]. BMC Nurs, 2021,20(1):79.DOI:10.1186/s12912-021-00599-y.
[25] Raymond L, Castonguay A, Doyon O, et al.Nurse practitioners' involvement and experience with AI-based health technologies: a systematic review[J]. Appl Nurs Res, 2022, 66:151604. DOI:10.1016/j.apnr.2022.151604.
[26] Kleib M, Chauvette A, Furlong K, et al.Approaches for defining and assessing nursing informatics competencies: a scoping review[J]. JBI Evid Synth,2021,19(4):794-841.DOI:10.11124/JBIES-20-00100.
[27] Huang H, Lee TT.Evaluation of ICU nurses' use of the clinical information system in Taiwan[J]. Comput Inform Nurs,2011,29(4):221-229.DOI:10.1097/NCN.0b013e3181fcbe3d.
[28] 中华人民共和国中央人民政府.关于印发进一步改善护理服务行动计划(2023-2025年)的通知[EB/OL].(2023-06-15). https://www.gov.cn/zhengce/zhengceku/202306/content_6887303.htm.
[29] 刘娟,徐培,任芳慧,等.基于信息化早期预警评分系统的早期康复护理在ICU重症肺炎机械通气患者中的应用[J].当代护士(中旬刊),2022,29(7):80-83.DOI:10.19792/j.cnki.1006-6411.2022.20.024.
[30] 蔡金霞,高永霞,黄红娟等.信息化风险评估预警系统在体外膜肺氧合患者安全转运中的应用[J]. 护士进修杂志,2023,38(4):367-370.DOI:10.16821/j.cnki.hsjx.2023.04.017.
[31] 邹晓娜,王春雨.信息化护理管理措施在重症医学科中的应用[J].世界最新医学信息文摘,2019,19(88):267-268.DOI:10.19613/j.cnki.1671-3141.2019.88.178.
[32] 李佳. 绿色通道流程信息化对重症哮喘合并呼吸衰竭病人抢救室滞留时间及家属护理工作满意度的影响[J].全科护理,2021,19(5):633-635.DOI:10.12104/j.issn.1674-4748.2021.05.016.
[33] 张军伟. 绿色通道流程信息化急诊护理对急性心肌梗死合并心房颤动患者抢救室滞留时间及护理满意度的影响[J].中国民康医学,2021,33(1):175-177.DOI:10.3969/j.issn.1672-0369.2021.01.069.
[34] 王静,曹英,李艳.DoCare7.0信息系统在CCU重症患者结构化电子护理记录的应用[J].护理学杂志,2022,37(8):39-40.DOI:10.3870/j.issn.1001-4152.2022.08.039.
[35] 林甜甜,衣沈妮,王季芹.互联网+时代远程护理在COPD居家患者延伸服务中的研究进展[J].齐鲁护理杂志,2020,26(11):106-108.DOI:10.3969/j.issn.1006-7256.2020.11.037.
[36] 程诺,王爱平.远程护理在老年癌症患者中应用的研究进展[J].中华现代护理杂志,2023,29(15):2095-2100. DOI:10.3760/cma.j.cn115682-20220829-04210.
[37] 史纪元,罗家音,王雪莲,等.国内外人工智能护理相关研究热点和趋势分析[J].军事护理,2023,40(7):16-19.DOI:10.3969/j.issn.2097-1826.2023.07.004.
[38] 王怡丹,周滢,王峥,等.护理-信息-工程学方向护理硕士专业学位研究生培养必要性的探索性研究[J].中华护理教育,2022,19(7):592-597.DOI:10.3761/j.issn.1672-9234.2022.07.003.
[39] 段丹,孔令磷,赵梦遐,等. 我国护理信息学课程设置现状探讨[J]. 医学信息学杂志,2021,42(8):86-89. DOI:10.3969/j.issn.1673-6036.2021.08.017.
[40] Castonguay A, Farthing P, Davies S, et al.Revolutionizing nursing education through AI integration: a reflection on the disruptive impact of ChatGPT[J]. Nurse Educ Today,2023,129:105916. DOI: 10.1016/j.nedt.2023.105916.

Metrics

Viewed

Full text

Abstract

Cited

Shared