NOTES FROM THE NET NOMAD...

The Internet has brought the spirit of global communication and collaboration to nurses and other healthcare professionals in ways never before thought possible. These resources are offered to expand your opportunities for discussion, reference, education and research.

Healthcare, like so many disciplines is filled with algorithms. They may be guides to diagnosis, treatment protocols, or other decision making tools to help us arrive at a conclusion. The Medical Algorithm Project at http://www.medal.org/index.html defines them as "any computation, formula, survey, or look-up table, useful in healthcare." This site has more than 4600 of them sorted into 46 categories, from anesthesia to transfusion medicine. The majority are text documents, but several of them have been incorporated into spreadsheets for rapid data entry and result retrieval.

Needlestick (http://www.needlestick.mednet.ucla.edu/): Needlestick is an expert system that is designed to aid a physician in the effective management and documentation of occupational exposures to blood and bodily fluid." It is an interactive Web site designed to assist clinicians providing care for those with sharps injuries.

There are a couple of dozen ACLS algorithms at the NY Emergency Room RN Site (http://www.nyerrn.com/er/acls.htm#alg). Several are arrhythmia specific while others present a more general overview. Searching Google for "nursing algorithm" yielded more than 20,000 sites, from the New Jersey Decision-Making Model Algorithm to clinical care guidelines.

The yes/no, if/then nature of algorithms make them perfectly suited to self-learning tools using presentation software like Microsoft PowerPoint (http://microsoft.com) or Open Office (http://www.openoffice.org). By linking individual responses to branches in the decision tree participants have the opportunity to observe various outcomes in response to their choices.

This approach has been worked into learning games. The CyberPatient Simulator at MD Choice (http://mdchoice.com/cyberpt/cyber.asp) has several interactive modules where you can explore treatment of Acute Coronary Syndrome, Leg Swelling, ACLS or PALS.

While the simulators at MDChoice allow you to change your answers in response to feedback, Trauma.Org takes a bit different approach. In their "Moulage" section (http://www.trauma.org/resus/moulage/moulage.html) you have an opportunity to engage in several clinical scenarios where you cannot change your responses and have to deal with the consequences of your choices. A bit sarcastic in its feedback, it seems more like a live teaching session.

Algorithms are useful tools for learning and when combined with computer resources can produce interactive applications at very low cost for use by academic or clinical educators.