JMIR Publications

ABSTRACT

Background:

Early ambulation has been demonstrated to enhance postoperative recovery in patients with lung cancer undergoing thoracoscopic surgery. However, there remain potential risks and controversies regarding the optimal timing of early ambulation in clinical practice. Therefore, it is necessary to construct a clinical decision support system for early ambulation to facilitate the translation of evidence into practice.

Objective:

This study aimed to construct a decision support system for early ambulation in patients with lung cancer undergoing thoracoscopic surgery and to verify its effectiveness in order to better assist medical staff in clinical decision-making.

Methods:

A systematic literature review conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and expert panel meetings were used to develop the knowledge base of the decision support system. Ten experts were invited to evaluate the wording, expression, applicability, and coding rationality of the knowledge base. A non-randomized, non-concurrent, pre-post control design was adopted to validate the effectiveness of the decision support system by examining the rate of ambulation within 2 h postoperatively, length of hospital stay, adverse outcomes, and nurses’ experiences following implementation of the system.

Results:

A total of 1270 eligible patients from the day surgery ward were enrolled to complete the validation of the knowledge-based decision support system for early ambulation. The rate of ambulation within 2 h postoperatively increased significantly from 83% to 90% following implementation of the system. Similarly, the length of hospital stay decreased after system application, and this reduction was statistically significant compared with the 6 months before implementation. The total score of the Clinical Nursing Information System Effectiveness Evaluation Scale was 96.93 ± 10.49, as evaluated by 14 nurses from the day surgery ward.

Conclusions:

A decision support system for early ambulation was successfully constructed and applied in clinical practice. The system achieved ambulation risk warning, intelligent decision-making, structured nursing records, and visual presentation of key data, and effectively increased the rate of ambulation within 2 h postoperatively while enhancing the standardisation of ambulation management. Clinical Trial: The study design was approved by the appropriate ethics review board (approval number: IS25150).