Nurses are accountable to apply the nursing process, which is key for patient care: It is a problem-solving process providing the structure for care plans and documentation. The state-of-the art nursing process is based on classifications that contain standardized concepts, and therefore, it is named Advanced Nursing Process. It contains valid assessments, nursing diagnoses, interventions, and nursing-sensitive patient outcomes. Electronic decision support systems can assist nurses to apply the Advanced Nursing Process. However, nursing decision support systems are missing, and no "gold standard" is available. The study aim is to develop a valid Nursing Process-Clinical Decision Support System Standard to guide future developments of clinical decision support systems. In a multistep approach, a Nursing Process-Clinical Decision Support System Standard with 28 criteria was developed. After pilot testing (N = 29 nurses), the criteria were reduced to 25. The Nursing Process-Clinical Decision Support System Standard was then presented to eight internationally known experts, who performed qualitative interviews according to Mayring. Fourteen categories demonstrate expert consensus on the Nursing Process-Clinical Decision Support System Standard and its content validity. All experts agreed the Advanced Nursing Process should be the centerpiece for the Nursing Process-Clinical Decision Support System and should suggest research-based, predefined nursing diagnoses and correct linkages between diagnoses, evidence-based interventions, and patient outcomes.
Both gaming and group (decision) support systems (GDSS) are frequently used to support decision-making and policymaking in multi-actor settings. Despite the fact that there are a number of ways in which gaming and GDSS can be used in a complementary manner, there are only sporadic examples of their combined use. No systematic overview or framework exists in which GDSS are related to the functions of gaming or vice versa. In this article, we examine, why, how and for what purpose GDSS can be used to enrich and improve gaming simulation for decision support, and vice versa. In addition to a review of examples found in the literature, four games are discussed where we combined gaming and GDSS for complex decision-making in a multi actor context: INCODELTA, a game about transportation corridors; INFRASTRATEGO, a game about a liberalizing electricity market; CONTAINERS A DRIFT, a game about the planning of a container terminal, and; DUBES, a game about sustainable urban renewal. Based on the literature and these four experiences, a classification is presented of (at least) four ways in which GDSS and gaming can be used in a complementary or even mutually corrective, manner: the use of GDSS for game design, for game evaluation, for game operation and the use of gaming for research, testing and training of GDSS.
In case of a major cyber incident, organizations usually rely on external providers of Cyber Incident Response (CIR) services. CIR consultants operate in a dynamic and constantly changing environment in which they must actively engage in information management and problem solving while adapting to complex circumstances. In this challenging environment CIR consultants need to make critical decisions about what to advise clients that are impacted by a major cyber incident. Despite its relevance, CIR decision making is an understudied topic. The objective of this preliminary investigation is therefore to understand what decision-making strategies experienced CIR consultants use during challenging incidents and to offer suggestions for training and decision-aiding. A general understanding of operational decision making under pressure, uncertainty, and high stakes was established by reviewing the body of knowledge known as Naturalistic Decision Making (NDM). The general conclusion of NDM research is that experts usually make adequate decisions based on (fast) recognition of the situation and applying the most obvious (default) response pattern that has worked in similar situations in the past. In exceptional situations, however, this way of recognition-primed decision-making results in suboptimal decisions as experts are likely to miss conflicting cues once the situation is quickly recognized under pressure. Understanding the default response pattern and the rare occasions in which this response pattern could be ineffective is therefore key for improving and aiding cyber incident response decision making. Therefore, we interviewed six experienced CIR consultants and used the critical decision method (CDM) to learn how they made decisions under challenging conditions. The main conclusion is that the default response pattern for CIR consultants during cyber breaches is to reduce uncertainty as much as possible by gathering and investigating data and thus delay decision making about eradication until the investigation is completed. According to the respondents, this strategy usually works well and provides the most assurance that the threat actor can be completely removed from the network. However, the majority of respondents could recall at least one case in which this strategy (in hindsight) resulted in unnecessary theft of data or damage. Interestingly, this finding is strikingly different from other operational decision-making domains such as the military, police and fire service in which there is a general tendency to act rapidly instead of searching for more information. The main advice is that training and decision aiding of (novice) cyber incident responders should be aimed at the following: (a) make cyber incident responders aware of how recognition-primed decision making works; (b) discuss the default response strategy that typically works well in several scenarios; (c) explain the exception and how the exception can be recognized; (d) provide alternative response strategies that work better in exceptional situations.
National forestry Commission (SBB) and National Park De Biesbosch. Subcontractor through NRITNational parks with large flows of visitors have to manage these flows carefully. Methods of data collection and analysis can be of help to support decision making. The case of the Biesbosch National Park is used to find innovative ways to figure flows of yachts, being the most important component of water traffic, and to create a model that allows the estimation of changes in yachting patterns resulting from policy measures. Recent policies oriented at building additional waterways, nature development areas and recreational concentrations in the park to manage the demands of recreation and nature conservation offer a good opportunity to apply this model. With a geographical information system (GIS), data obtained from aerial photographs and satellite images can be analyzed. The method of space syntax is used to determine and visualize characteristics of the network of leisure routes in the park and to evaluate impacts resulting from expected changes in the network that accompany the restructuring of waterways.
The focus of the research is 'Automated Analysis of Human Performance Data'. The three interconnected main components are (i)Human Performance (ii) Monitoring Human Performance and (iii) Automated Data Analysis . Human Performance is both the process and result of the person interacting with context to engage in tasks, whereas the performance range is determined by the interaction between the person and the context. Cheap and reliable wearable sensors allow for gathering large amounts of data, which is very useful for understanding, and possibly predicting, the performance of the user. Given the amount of data generated by such sensors, manual analysis becomes infeasible; tools should be devised for performing automated analysis looking for patterns, features, and anomalies. Such tools can help transform wearable sensors into reliable high resolution devices and help experts analyse wearable sensor data in the context of human performance, and use it for diagnosis and intervention purposes. Shyr and Spisic describe Automated Data Analysis as follows: Automated data analysis provides a systematic process of inspecting, cleaning, transforming, and modelling data with the goal of discovering useful information, suggesting conclusions and supporting decision making for further analysis. Their philosophy is to do the tedious part of the work automatically, and allow experts to focus on performing their research and applying their domain knowledge. However, automated data analysis means that the system has to teach itself to interpret interim results and do iterations. Knuth stated: Science is knowledge which we understand so well that we can teach it to a computer; and if we don't fully understand something, it is an art to deal with it.[Knuth, 1974]. The knowledge on Human Performance and its Monitoring is to be 'taught' to the system. To be able to construct automated analysis systems, an overview of the essential processes and components of these systems is needed.Knuth Since the notion of an algorithm or a computer program provides us with an extremely useful test for the depth of our knowledge about any given subject, the process of going from an art to a science means that we learn how to automate something.
The energy transition is a highly complex technical and societal challenge, coping with e.g. existing ownership situations, intrusive retrofit measures, slow decision-making processes and uneven value distribution. Large scale retrofitting activities insulating multiple buildings at once is urgently needed to reach the climate targets but the decision-making of retrofitting in buildings with shared ownership is challenging. Each owner is accountable for his own energy bill (and footprint), giving a limited action scope. This has led to a fragmented response to the energy retrofitting challenge with negligible levels of building energy efficiency improvements conducted by multiple actors. Aggregating the energy design process on a building level would allow more systemic decisions to happen and offer the access to alternative types of funding for owners. “Collect Your Retrofits” intends to design a generic and collective retrofit approach in the challenging context of monumental areas. As there are no standardised approaches to conduct historical building energy retrofits, solutions are tailor-made, making the process expensive and unattractive for owners. The project will develop this approach under real conditions of two communities: a self-organised “woongroep” and a “VvE” in the historic centre of Amsterdam. Retrofit designs will be identified based on energy performance, carbon emissions, comfort and costs so that a prioritisation strategy can be drawn. Instead of each owner investing into their own energy retrofitting, the neighbourhood will invest into the most impactful measures and ensure that the generated economic value is retained locally in order to make further sustainable investments and thus accelerating the transition of the area to a CO2-neutral environment.
