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Objective:To design and develop an unplanned extubation clinical decision support system, aiming to provide a reference for nurses' clinical decision-making.Methods:Through literature review and expert consultation, the knowledge base of the clinical decision support system for unplanned extubation was constructed, and the system function and interface were designed.Results:The authoritative coefficients of the two rounds of expert consultation were 0.853 and 0.867, respectively, and the Kendall ′s W were 0.458 and 0.492, respectively. The final built knowledge base included catheter evaluation module, unplanned extubation evaluation module, and knowledge reasoning rule module. At present, the knowledge base had sorted out 48 first-level items, 9 second-level items, 72 third-level items in the catheter evaluation module, and 5 first-level items, 12 second-level items, and 73 third-level items in the unplanned extubation evaluation module. Entry, 40 knowledge reasoning rules. Conclusions:The clinical decision-making system for unplanned extubation has changed the implementation of unplanned extubation risk early warning, optimized the management process, and realized the interaction of the hospital system. It can conduct dynamic unplanned extubation risk assessment based on individualization and assist nurses Make clinical decisions and promote the safety of nursing management.
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Objective:To provide reference for the development of a more intelligent and systematic nursing clinical decision support system based on the concept of precision nursing and data sharing, the nursing plan module of clinical decision support system.Methods:An evidence-based knowledge base was constructed based on the nursing process and the standardized nursing terminologies; the nursing plan module was designed according to clinical needs, and the logical reasoning rules were formulated from the generation, sequencing and stopping of nursing problems, objectives, measures and activities, and finally the nursing plan module of clinical decision support system was formed.Results:The nursing plan module of clinical decision support system included the basic information of patients, positive evaluation items and weight values, nursing problems, objectives, measures and activities, etc. the module could automatically deduce the nursing plan according to the patient's individual characteristic index (positive evaluation item), and sort the nursing problems and corresponding measures and activities according to the generation time, weight value and correlation degree. It could automatically distinguish nursing problems, goals, measures and the time of activity stop, and realize intelligent decision-making.Conclusion:The interface of nursing plan module of this system is clear and logical reasoning rules are rigorous. It breaks through the bottleneck of nursing decision-making based on personal professional knowledge and experience in clinical situation for a long time, which can ensure the homogeneity of nursing plan and improve the correctness of decision-making.
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Objective To investigate the current status of subjective well-being in patients with coronary heart disease (CHD) undergoing Percutaneous Coronary Interventions and its influence factors. Methods Totally 140 cases of coronary heart disease undergoing percutaneous coronary interventions were investigated with the general information questionnaire, General Well-being Scale, Self-rating Anxiety Scale and Self-rating Depression Scale, and analyzed the influence factors of subjective well-being. Results There were patients whose subjective well-being scores were lower than the average of Chinese norm among the 140 CHD patients,which took a proportion of 75.71%(106/140).The subjective well-being score in male patients was 73.33±6.43,which was lower than 75.00±15.00 of the Chinese norm (t=-2.112,P<0.05).The subjective well-being score in female patients was 65.15±8.32,which was lower than 71.00 ± 18.00 of the Chinese norm (t=-5.981, P<0.01); the self-rated health status and anxiety disorder were the main factors of subjective well-being in coronary heart disease undergoing Percutaneous Coronary Interventions patients. Conclusions The subjective well- being of patients with CHD undergoing percutaneous coronary interventions is poor; the society and family should give them much enough care and support, and effective psychological intervention measures should be taken to improve their subjective well-being.