Dear Colleagues,

If one phrase could describe how the use of Information Communication Technology (ICT) has evolved within healthcare delivery, it would be ICT paradigm shift. The role of ICT in healthcare delivery has been increasing since the 1980s to become an essential aspect of health care delivery [1]. Its impetus for use in nursing or midwifery practice is to enhance clinical practice rather than serving administrative or managerial purposes [2]. Its integration into health care delivery is referred to as eHealth or informatics. The World Health Organization published a ‘National eHealth Strategy Toolkit’ [3], reflecting a global drive to improve patient safety, outcomes, healthcare accountability and transparency through the use of ICT. This policy document builds on seminal patient safety documents, such as “To Err is Human” [4] or “Keeping Patients Safe” [5] that point specifically to how integrating technology in healthcare positively affects patient outcomes. Nevertheless, nurses have mixed views about using ICT in patient care delivery. Some nurses worry about losing the human touch [6] while others are more positive [7]. Given that nurses are the largest group of healthcare workers in health settings their current attitudes, knowledge and practices related to ICT and eHealth are of critical interest. In this supplement, nurses and midwives insight into how they use ICT and eHealth within their practice is not perceived in a vacuum but rather within a dynamic ICT paradigm shift.

Dr. Sile A. Creedon
Guest Editor

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References

1. Gürdaş Topkaya, S.; Kaya, N. Nurses' computer literacy and attitudes towards the use of computers in health care. J. Nurs. Pract. 2015, 21, 141–149.
2. Kohn, L.; Corrigan, J; Donaldson, S. To Err Is Human: Building a Safer Health System; National Academy Press: Washington, DC, USA, 2000.
3. Page, A. Keeping Patients Safe: Tranforming the Work Environment of Nurses, Washington, National Academies Press: Washington, DC, USA, 2004.
4. Petit Dit Dariel, O.; Wharrad, H; Windle, R. Exploring the underlying factors influencing e-learning adoption in nurse education. Adv. Nurs. 2013, 69, 1289–1300.
5. Ridgway, L.; Mitchell, C.; Sheean, F. Information and communication technology (ICT) use in child and family nursing: What do we know and where to now? Nurse 2011, 40, 118–129.
6. National eHealth Strategy Toolkit; World Health Organization: Geneva, Switzeland, 2012.
7. Yu, S.; Chen, I.J.; Yang, K.-F.; Wang, T.-F.; Yen, L.-L. A feasibility study on the adoption of e-learning for public health nurse continuing education in Taiwan. Nurse Educat. Today, 2007, 27, 755–761.

Title: Modelling the ontology of an expert evidence-adaptive knowledge base for a Pressure Injury Clinical Decision Support System

Authors: Khong, P.C.B., Hoi, S.Y., Lee, L.N., Dawang Jr, A.I.

Abstract: The selection of an appropriate wound product for treatment of pressure injury is paramount in promoting wound healing. However, nurses find it difficult to decide on the most optimal wound product(s) due to limited live experiences in managing pressure injuries resulting from successfully implemented pressure injury prevention programs. The challenges of effective decision-making in wound treatment(s) by nurses at the point of care are compounded by the yearly release of wide arrays of newly researched wound products in the consumer market. A clinical decision support system for pressure injury (PI-CDSS) was built to facilitate effective decision-making and selection of optimal wound treatment(s). This paper describes the development of a PI-CDSS with an expert knowledge base via the integrated/ interactive development environment using a Blaze Advisor. A conceptual framework using decision-making and decision theory, knowledge representation and process modelling guided the construct of the PI-CDSS. This expert system has incorporated the practical and relevant decision knowledge of wound experts in assessment and wound treatments in its algorithm. The ontology of the PI-CDSS is adaptive with high scalable capabilities and interoperability to interface with other existing clinical and administrative systems. The algorithm that was formative evaluated and tested for usability. The treatment modalities generated after using patient-specific assessment data were found to be consistent with the treatment plan(s) proposed by the wound experts. The overall level of agreements were acceptable between the wound experts and the generated treatment modalities for the choice of wound products, instructions and alerts. The PI-CDSS serves as a just-in-time wound treatment protocol with suggested clinical actions for nurses. Nurses can now effectively treat wound with the best evidence available.

Keywords: clinical decision support system; ontology; expert system; development; pressure injury; nurses; wound treatment