Construction And Clinical Applying Evaluation Of Cloud Computing Based Operating Room Mobile Nursing Information System

ObjectiveCloud computing is the new computer network technology emerged recent decade,with the feature of obtaining at any time.Cloud computing is not only the destination of digitalization and information of hospital in the near future,but also adapted to the current Chinese new medical healthy reformation.Mobile nursing information system(MNIS)is the important component of the hospital information system(HIS),which has been run in some 3A hospitals,mainly applied in ward nursing workflow.Since operating room(OR)is an important platform,surgical nursing safety is top priority,which is key to intact medical and nursing quality and safety of the hospital.Digitalization of surgical nursing information would improve the quality and safety in theory.For OR MNIS just startup,there is no comprehensive assessment system for OR MNIS.So specific aims of the study were to construct an OR MNIS based on cloud computing,and to establish an assessment system to evaluate the OR MNIS,and to evaluate the hospital OR MNIS by the assessment system to observe the OR MNIS clinical effects on nursing quality and safety.MethodsThe team including information technology(IT)engineers,software architect and operating room nursing sisters were involved in the hospital MNIS construction.According to characters and requirements of surgical nursing care,Hospital Information System(HIS),Radio Frequency Identification(RFID)systems,code scan recognition system,human resource systems,Operating Room scheduling system,Nursing system and items inventory system were integrated.Before clinical running,the MNIS was test in simulated clinical circumstances to detect and amend defects.Based on principles of scientificity,materiality,efficiency,specificity,sensitivity,independency,feasibility and conciseness,the draft of OR MNIS assessment system was made by experts meeting according to "recommended practices for documentation of perioperative nursing care" of the association of perioperative registered nurse(AORN)and "The criteria and monitoring indexes for operating room nursing care quality"(2016,issued by the Association of Perioperative nurse of Jiangsu Province).Afterwards,the draft was processed 3 rounds expert consulting with Delphi method to establish the OR MNIS assessment system.Finally effects of O MNIS on perioperative nursing care quality and safety were retrospective analyzed by the OR MNIS assessment system.Meanwhile,factors influence OR MNIS clinical application were evaluated with questionnaire survey in OR nurses.Results1.An OR MNIS under cloud computing adapting to the hospital operating room characters was constructed,which included both perioperative nursing care workflow,and operating room nursing care management.2.A comprehensive assessment system for OR MNIS clinical application was established with Delphi experts'consultation method,including three grades with 3 items of the first grade,8 items of the second grade,24 items of the third grade.The assessment system not only includes clinical nursing care indicators,but also involve general hardware and software indicators.3.It took less time to finish patient handover by using the cloud computing based MNIS than the traditional group(3.52 ± 0.21 vs 6.78 ± 0.54,p<0.05).Although all nursing staff finished operation safety checklist,execution standard rate and nursing documents qualified arte were higher in MNIS group(99.7%vs 84.3%and 99.8%vs 91.4%respectively,both p<0.01),and prophylactic antibiotics administrating standard rate was also higher in the experimental group(99.8%vs 96.3%,p<0.05).4.It was shown training before OR MNIS clinical application,supporting from the department and convenience of patients' information verification were top 3 favorable factors for clinical application.However,the poor signal of Wi-Fi,inconvenience of PDA input and the small screen size were top 3 adverse factors.Conclusions1.OR MNIS based on cloud computing includs both perioperative nursing care workflow,and operating room nursing care management.2.The comprehensive MNIS assessment system not only includes clinical nursing care indicators,but also involve general hardware and software indicators.3.Application the cloud computing based mobile station would improve not only operating room nursing safety but also efficiency.4.Although OR MNIS provides convenience for clinical application,there still were some hardware defects needed to be improved,especially Wi-Fi signal in operating room.