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Title WWW-Based Applications for the Neonatal Intensive Care Unit
Author(s) Charles Hu and Ray Duncan
Source Pediatrics (Suppl.), Vol. 104, No. 3, Pages 671-671
Publication Date Sept. 1999
Abstract Background: Computerized decision-support applications can simplify the process of ordering drugs and solutions in the Neonatal Intensive Care Unit (NICU) and reduce the incidence of calculation errors. The World Wide Web (WWW) has made it possible to rapidly build and deploy such applications in a platform-independent manner. Methods: Parallel versions of several WWW-based applications for the NICU were developed in both client-side JavaScript and server-side Microsoft Active Server Pages (ASP) to test performance and portability on a variety of WWW browsers. Certain of the applications were previously implemented in Microsoft Basic, VAX RDB, Apple HyperCard, or Symantec ThinkC. Information is collected from the clinician via Hyper Text Markup Language (HTML) "forms" displayed in a WWW browser. Calculations are carried out on the client (JavaScript versions) or on the server (ASP versions), using information stored on the server. The results are delivered to the user via the browser. Graphs and charts are created dynamically and embedded in WWW pages using ServerObjects' ASPChart, an ActiveX module that can be called from an ASP application to generate JPEG images. Results: The four WWW-based patient-care applications listed below are now in routine use in the CSMC NICU. (1) Quick IV: The physician supplies the patient's weight and the desired amount of fluids, dextrose, sodium, potassium, calcium, and heparin per unit weight per day. The application calculates the exact amounts of fluids, dextrose, electrolytes, and heparin to mix in the IV solution, along with the delivery rate. (2) Quick Drip: The physician selects a constant infusion medication from a list and supplies the patient's weight, the desired volume per hour, and the desired dose-per-weight-per-unit time. The application checks the dosage against built-in limits and calculates the amount of drug to be mixed in a standard volume. (3) Code Sheet: The physician supplies the patient's name, weight, and birth-date. The application calculates patient-specific dosages for drugs used during a neonatal resuscitation, and generates a "Code Sheet" that can be printed and posted at the bedside for ready reference during an emergency. (4) Growth Chart: The application generates three different charts of weight and head circumference for the period from 24 weeks gestation to term-plus-three-months, based on curves published in the pediatric literature, and plots the patient's weights on the curves. Conclusion: The explosion of the Internet and the WWW, and the proliferation of low-cost, powerful, easy-to-use devel-opment tools for WWW servers and applications, have made it easy to build user-friendly, graphically-enabled, platform-independent decision support appli-cations for physicians and nurses working in the NICU. These applications can be accessed from clinical workstations throughout the patient care areas, as well as the desktop computers in the physician and nurse offices.


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