A computerised guideline for pressure ulcer prevention

This paper illustrates the implementation of a computerised guideline for p ressure ulcer prevention. In particular, it describes the aspects related t o the site-specification of a guideline delivered by the Agency for Health Care Policy Research (AHCPR), to its integration with the electronic patien t record, and to its implementation within the clinical routine. The primar y goal of the system is both to facilitate nurses assessing the risk of ulc er development, and to manage patients at risk by producing daily preventio n work-plans. Concerning this functionality, particular attention has been paid to manage nurse's non-compliance with the guideline suggestions and to collect data for evaluating the guideline impact. Moreover, since it is we ll known that nurses are often over-loaded, the human computer interaction has been studied in such a way to optimise the time spent for data input. A n additional functionality of the system is the novice nurses' education - they can browse a graphical representation of the guideline, asking details about the different tasks, and they can simulate patients to obtain real-t ime advice. The educational tool is written in Java and it is based on a re presentation of the guideline as a relational database. A preliminary evalu ation of the system has been performed and the results are presented on the management of about 40 patients. (C) 2000 Elsevier Science Ireland Ltd. Al l rights reserved.