Support for Clinical Decision Making. Formalizing & Implementing Practice Guidelines: Indexing Guidelines: Applications in Use of Pulmonary Artery Catheters and Pressure Ulcer Prevention

In a busy clinical environment, access to knowledge must be rapid and specific to the clinical query at hand. This requires indices which support easy navigation within a knowledge source. We have developed a computer-based tool for trouble-shooting pulmonary artery waveforms using a graphical index. Preliminary results of domain knowledge tests for a group of clinicians exposed to the system (N=33) show a mean improvement on a 30-point test of 5.33 (p<0.001) compared to a control group (N=19) improvement of 0.47 (p=0.61). Survey of the experimental group (N=25) showed 84% (p=0.001) found the system easy to use. We discuss lessons learned in indexing this domain area to computer-based indexing of guidelines for pressure ulcer prevention.