Nurse-led Design and Development of an Expert System for Pressure Ulcer Management

Abstract

The use of Clinical Practice Guidelines (CPGs) in clinical settings is known to enable care delivery with better health outcomes while promoting a consistent way of treating patients in different care settings. In this work, a user-centered design approach involving nurses was followed to develop a prototype expert system for modelling CPGs for Pressure Ulcer management. The system was developed using Visirule, a software tool for designing expert systems that uses a graphical approach to modeling knowledge. The resulting system was evaluated by 5 staff nurses that compared nurses’ time and accuracy to assess a wound and recommend a dressing using CPGs accessed via the Intranet of an NHS Trust vis a vis the prototype expert system. A post task qualitative evaluation revealed that nurses found the system useable with a systematic design, that it increased access to CPGs by reducing the time and effort required by other usual methods of access, that it provided opportunities for learning due to its interactive nature, and that its recommendations were more actionable that those provided by usual static CPG documents.

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