Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
4
pubmed:dateCreated
2010-6-23
pubmed:abstractText
Variations in nursing care have been observed, affecting patient outcomes and quality of care. Case-based reasoners that benchmark for patient indicators can reduce variation through decision support. This study evaluated and validated a case-based reasoning application to establish benchmarks for nursing-sensitive patient outcomes of pain, fatigue, and toilet use, using patient characteristic variables for generating similar cases. Three graduate nursing students participated. Each ranked 25 patient cases using demographics of age, sex, diagnosis, and comorbidities against 10 patients from a database. Participant judgments of case similarity were compared with the case-based reasoning system. Feature weights for each indicator were adjusted to make the case-based reasoning system's similarity ranking correspond more closely to participant judgment. Small differences were noted between initial weights and weights generated from participants. For example, initial weight for comorbidities was 0.35, whereas weights generated by participants for pain, fatigue, and toilet use were 0.49, 0.42, and 0.48, respectively. For the same outcomes, the initial weight for sex was 0.15, but weights generated by the participants were 0.025, 0.002, and 0.000, respectively. Refinement of the case-based reasoning tool established valid benchmarks for patient outcomes in relation to participants and assisted in point-of-care decision making.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:status
MEDLINE
pubmed:issn
1538-9774
pubmed:author
pubmed:issnType
Electronic
pubmed:volume
28
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
235-40
pubmed:meshHeading
pubmed-meshheading:20571376-Activities of Daily Living, pubmed-meshheading:20571376-Adult, pubmed-meshheading:20571376-Age Factors, pubmed-meshheading:20571376-Algorithms, pubmed-meshheading:20571376-Benchmarking, pubmed-meshheading:20571376-Comorbidity, pubmed-meshheading:20571376-Decision Support Systems, Clinical, pubmed-meshheading:20571376-Evidence-Based Practice, pubmed-meshheading:20571376-Fatigue, pubmed-meshheading:20571376-Female, pubmed-meshheading:20571376-Humans, pubmed-meshheading:20571376-Nurse's Practice Patterns, pubmed-meshheading:20571376-Nursing Assessment, pubmed-meshheading:20571376-Nursing Evaluation Research, pubmed-meshheading:20571376-Outcome Assessment (Health Care), pubmed-meshheading:20571376-Pain, pubmed-meshheading:20571376-Patient Care Planning, pubmed-meshheading:20571376-Pilot Projects, pubmed-meshheading:20571376-Point-of-Care Systems, pubmed-meshheading:20571376-Problem Solving, pubmed-meshheading:20571376-Quality Indicators, Health Care, pubmed-meshheading:20571376-Sex Factors
pubmed:articleTitle
Supportive decision making at the point of care: refinement of a case-based reasoning application for use in nursing practice.
pubmed:affiliation
Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Ontario, Canada. tammie.dipietro@utoronto.ca
pubmed:publicationType
Journal Article, Research Support, Non-U.S. Gov't, Evaluation Studies