Abstract
This paper poses four critical questions concerning the development and use of expert decision support systems for nursing: (1) Can such systems be created? (2) Can such systems be effectively and efficiently disseminated? (3) Will nurses actually use these systems? (4) Will such systems positively affect patient outcomes? Some issues and points of view that surround these questions are presented and discussed.
In particular, the COMMES Nursing Consultant System is discussed in light of the questions presented. From the experience of the COMMES system, the following points of view are advanced: (1) Systems can be created although some argue the associative network approach is far more appropriate for nursing than rule-based systems. (2) Systems can be successfully disseminated. (3) COMMES is used by nurses in primarily clinical but also visionary educational settings too. (4) Beginning evidence demonstrates measurable positive patient outcomes, although far more evaluative work is needed.
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