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Objective to understand the prenatal genetic testing decision-making processes among pregnant Korean-American women. Design a qualitative, descriptive research design. Participants referrals and snowball sampling techniques were used to recruit 10 Korean-American women who had been recommended for amniocentesis during pregnancy in the United States (U.S.). All participants were born in Korea and had immigrated to the U.S. The number of years living in the U.S. ranged from 4 to 11 (M=5.7). Setting various regional areas of the U.S. Measurements and Findings the researchers conducted face-to-face or phone interviews using semi-structured interview guides. The interviews were conducted in the Korean language and lasted approximately 50–100 minutes. The interview guides focused on the decision-making process and experiences with prenatal genetic testing, as well as reflections on the decisions. Four core themes emerged related to the participants’ decision-making processes, according to their descriptions. These themes are (1) facing the challenges of decision-making, (2) seeking support, (3) determining one's preferred role in the decision-making process, and (4) feeling uncomfortable with the degree of patient autonomy in U.S. health care. Key conclusion researchers concluded that many distinctive factors influence the decision-making processes used by pregnant Korean-American women. The results have the potential to improve shared decision-making practices regarding prenatal genetic testing. Implications for Practice clinicians need to understand the sociocultural underpinnings of pregnant Korean-American immigrants regarding prenatal genetic screening and testing as an initial step to engage these patients in shared decision-making. [ABSTRACT FROM AUTHOR]

Abstract: Objective: A rule-based prototype decision support tool; Braden-scale based Automated Risk-assessment Tool (BART) was developed to test whether pressure ulcer risk scores can be determined automatically based on the documented patient data. Methods: The data items required for assessing pressure ulcer risk were identified by analyzing the parameter definitions of the Braden scale and by consulting the nurses specialized in pressure ulcer prevention and care. Documentation coverage and formats of the required data was evaluated. The decision rules were developed based on the inputs from the expert nurses, and were implemented as a web-based prototype tool, BART. The agreement rates between nurses and BART on assigning scores to the six Braden-scale parameters were calculated with 39 convenience samples of patient data. Results: Although several items required for the automated decision were not found from the documentation, the majority of the required data items were documented with feasible formats (i.e., coded lists or free text with nominal or numeric values) for algorithmic processing. When evaluated with 39 test cases, BART and the nurses showed varying levels of agreement (from “slight” to “substantial”) on assigning scores for the six parameters of the Braden scale. They showed “fair” level of agreement with an “at risk” decision. Conclusion: BART has limitations that need to be addressed through future enhancements. However, it demonstrates potential for reuse of documented patient data to automatically populate pressure ulcer risk using the Braden scale. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: Clinical practice guidelines (CPGs) are common tools for clinicians in daily practice. In order to use CPGs effectively at the point of care, representing CPGs into computer-interpretable format is essential. Since computer-interpretable guidelines (CIGs) have been reported to increase clinicians’ usage of guidelines and improve patient''s outcomes, it is critical to assess health care knowledge translated from CPGs into CIGs. The overall goal of this study was to illustrate the steps involved in encoding a guideline in guideline interchange format-3 (GLIF3) through a case study of a depression screening and management CPG for a nursing decision support system (DSS). Methods: This study consisted of five steps: (1) Selection of a CPG; (2) extraction and categorization in GLIF3 of concepts related to depression screening and management tasks; (3) converting GLIF3 steps to a flowchart; (4) creation of scenarios representing possible execution paths; (5) guideline execution engine (GLEE) execution of scenarios. Discussion: This study contributes to the body of knowledge regarding creation of CIGs and the use of GLEE as an evaluation tool for the encoded CIG in GLIF format for a depression CPG. CPG representation using GLIF3 and its evaluation by GLEE are useful methods to prepare nursing CPGs for implementation in a DSS. [Copyright &y& Elsevier]