Biomedical subjects

K E Bradshaw

Publications and source records attributed to K E Bradshaw.

4 recordsLinked to original sources

PubMed1989

Development of a computerized laboratory alerting system.

Using the capabilities of the HELP medical information system at LDS Hospital, a Computerized Laboratory Alerting System (CLAS) was developed. CLAS monitors and alerts for the presence of life-threatening conditions in hospitalized patients which are indicated by laboratory test results. Alerts are posted on computer terminals on the hospital's nursing divisions, where they are reviewed and acknowledged by hospital staff so that appropriate treatment can be rapidly instituted. CLAS was evaluated to determine its effectiveness in relaying alerts to the clinical staff, and improvements were made to develop an effective user interface. Initial average alert response times on nursing divisions ranged from 5.1 to 58.2 hr. The average alert response time dropped to 3.6 hr when alert review was integrated with laboratory result review, and to 0.1 hr after installation of a flashing light to notify hospital staff of the presence of new alerts.

Clinical Laboratory Information Systems↗

PubMed1989

Computerizing the intensive care unit: current status and future directions.

Computers are serving intensive care patients by simplifying and improving the accuracy of data acquisition, facilitating communications, storing and organizing patient records, and providing expert suggestions. The future will bring many changes in the way nurses practice in intensive care. The computer should be considered an evolutionary tool to help effect these changes.

Communication↗

PubMed1984

Physician decision-making--evaluation of data used in a computerized ICU.

New instrumentation, techniques and computers have made such large amounts of information rapidly available to ICU clinicians that there is now a danger of information overload. To help with this problem at LDS Hospital, a computerized system was implemented in the Shock-Trauma ICU. This ICU is almost totally computerized with each patient's physiologic, laboratory, drug, demographic, fluid input/output and nutritional data integrated into the patient's computer record. In the ICU, physician decision-making takes place in two situations: during rounds and on-site. For this study, data usage in decision-making was evaluated in both of these environments. The items of data used in decision-making were tabulated into six categories: bedside monitor, laboratory, drugs, input/output and IV, blood gas laboratory, observations and other. Comparisons were made between the portion of the computerized database occupied by a category and its use in decision-making. Combined laboratory data (clinical, microbiology and blood gas) made up 38 to 41% of total patient data reviewed and occupied 16.3% of the database. Observations made up 21-22% of the data reviewed and occupied 6.8% of the database. Drugs, input/output and IV data usage ranged from 13% to 23%, but occupied 36% of the database. Bedside monitor data usage was 12.5% to 22% and occupied 32.5% of the database. The 'other' category, used 2.5% to 5% of the time, made up 8.4% of the database. These results indicate that patient data collection and storage must be evaluated and optimized. This evaluation, along with implementation of the computerized ICU Rounds Report developed for optimal data presentation, will help physicians to evaluate patient status and should facilitate effective decisions.

Diagnosis, Computer-Assisted↗

PubMedDate not supplied

Computer-based data entry for nurses in the ICU.

Efforts are being made to improve the efficiency and quality of care in intensive care units (ICUs) at Latter Day Saints Hospital. The ICUs have been computerized, and the collection, storage, and presentation of patients' data have been improved. Nurses use computers for entering clinical data and plans for nursing care, and the effects of these changes on the work patterns of nurses in the ICU have been evaluated. Contrary to our expectation, our studies showed a decrease in the proportion of time that nurses spent in direct patient care (from 49.1% to 43.2%) and an increase in the proportion they spent entering clinical data (from 18.2% to 24.2%) after computerization. These changes, however, were attributed to a decrease in the severity of patients' illnesses, rather than the availability of the computer. There was no measurable difference in the proportion of time spent at other nursing activities.

Data Interpretation, Statistical↗