Designing the User Interface of a Nitroglycerin Dose Titration Decision Support System: User-Centered Design Study.


Journal

Applied clinical informatics
ISSN: 1869-0327
Titre abrégé: Appl Clin Inform
Pays: Germany
ID NLM: 101537732

Informations de publication

Date de publication:
May 2024
Historique:
medline: 26 7 2024
pubmed: 26 7 2024
entrez: 24 7 2024
Statut: ppublish

Résumé

 Nurses adjust intravenous nitroglycerin infusions to provide acute relief for angina by manually increasing or decreasing the dosage. However, titration can pose challenges, as excessively high doses can lead to hypotension, and low doses may result in inadequate pain relief. Clinical decision support systems (CDSSs) that predict changes in blood pressure for nitroglycerin dose adjustments may assist nurses with titration.  This study aimed to design a user interface for a CDSS for nitroglycerin dose titration (  A user-centered design (UCD) approach, consisting of an initial qualitative study with semistructured interviews to identify design specifications for prototype development, was used. This was followed by three iterative rounds of usability testing. Nurses with experience titrating nitroglycerin infusions in coronary care units participated.  A total of 20 nurses participated, including 7 during the qualitative study and 15 during usability testing (2 nurses participated in both phases). Analysis of the qualitative data revealed four themes for the interface design to be (1) clear and consistent, (2) vigilant, (3) interoperable, and (4) reliable. The major elements of the final prototype included a feature for viewing the predicted and actual blood pressure over time to determine the reliability of the predictions, a drop-down option to report patient side effects, a feature to report reasons for not accepting the prediction, and a visual alert indicating any systolic blood pressure predictions below 90 mm Hg. Nurses' ratings on the questionnaires indicated excellent usability and acceptability of the final  This study successfully applied a UCD approach to collaborate with nurses in developing a user interface for the

Sections du résumé

BACKGROUND BACKGROUND
 Nurses adjust intravenous nitroglycerin infusions to provide acute relief for angina by manually increasing or decreasing the dosage. However, titration can pose challenges, as excessively high doses can lead to hypotension, and low doses may result in inadequate pain relief. Clinical decision support systems (CDSSs) that predict changes in blood pressure for nitroglycerin dose adjustments may assist nurses with titration.
OBJECTIVE OBJECTIVE
 This study aimed to design a user interface for a CDSS for nitroglycerin dose titration (
METHODS METHODS
 A user-centered design (UCD) approach, consisting of an initial qualitative study with semistructured interviews to identify design specifications for prototype development, was used. This was followed by three iterative rounds of usability testing. Nurses with experience titrating nitroglycerin infusions in coronary care units participated.
RESULTS RESULTS
 A total of 20 nurses participated, including 7 during the qualitative study and 15 during usability testing (2 nurses participated in both phases). Analysis of the qualitative data revealed four themes for the interface design to be (1) clear and consistent, (2) vigilant, (3) interoperable, and (4) reliable. The major elements of the final prototype included a feature for viewing the predicted and actual blood pressure over time to determine the reliability of the predictions, a drop-down option to report patient side effects, a feature to report reasons for not accepting the prediction, and a visual alert indicating any systolic blood pressure predictions below 90 mm Hg. Nurses' ratings on the questionnaires indicated excellent usability and acceptability of the final
CONCLUSION CONCLUSIONS
 This study successfully applied a UCD approach to collaborate with nurses in developing a user interface for the

Identifiants

pubmed: 39048084
doi: 10.1055/s-0044-1787755
doi:

Substances chimiques

Nitroglycerin G59M7S0WS3

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

583-599

Informations de copyright

Thieme. All rights reserved.

Déclaration de conflit d'intérêts

None declared.

Auteurs

Navpreet Kamboj (N)

Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada.

Kelly Metcalfe (K)

Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada.
Women's College Hospital Research and Innovation Institute, Toronto, Canada.

Charlene H Chu (CH)

Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada.
KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Canada.

Aaron Conway (A)

School of Nursing, Queensland University of Technology (QUT), Brisbane, Australia.

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Classifications MeSH