看護支援システムによる看護診断の有用性の検討

Usefulness of Nursing Support System in Nursing Diagnosis

　近年，看護診断過程に看護支援システムを導入する医療施設が増えている．しかしながら，看護支援システムが，看護診断の正確性や効率性にどの程度寄与するかは明らかにされていない．本研究では，Lunneyの著書から2事例を選び，事例に対する看護診断の正答率および正確度と回答時間を評価した．研究デザインは，被験者（看護師）を看護支援システム使用群と非使用群に無作為に割り付けたクロスオーバーデザインを採用した．正確度の評価尺度としてLunneyの尺度を用いた．正答率および正確度は両群で差がみられなかったが，各事例とも回答時間はシステム使用群で有意に短かった．回答時間の長短に影響を与える因子をシステム使用の有無，被験者の背景から探索するために重回帰分析を行ったところ，他の独立因子の影響を補正した結果として，「システム使用の有無」が有意に回答時間に影響することが示唆された．以上より，看護支援システムは，看護診断の正確性を損なわずに回答時間を短縮させる利点があると考えられた．

　In recent years, medical institutions are increasingly introducing a nursing support system to their process of nursing diagnosis. However, it remains to be clarified whether the nursing support system contributes to accuracy of nursing diagnosis and to efficient nursing. We studied whether nursing support system improved correct diagnosis rate and accuracy of diagnosis and whether it shortened the time of diagnosis. We performed randomized crossover trial using two kinds of paper patients in 42 subject surses. The subjects were divided into those who used nursing support system and those who not. Accuracy of nursing diagnosis was judged by using Ordinal Scale for Degree of Accuracy (Lunney, 1990). The time of diagnosis was found to be significantly shorter in the subjects who used nursing support system than those who not. There were no statistical differences in the correct diagnopsis rate and the accuracy of diagnosis between the two subjects. Multiple regression analysis revealed that use of nursing support system was the only significant factor associated with the time of diagnosis among various background factors of the subjects. These results suggest that the nursing support system can contribute to efficient nursing without deteriorating accuracy of nursing diagnosis.