Nursing Informatics – Clinical Decision Support System

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Nursing Informatics – Clinical Decision Support System

Clinical decision support systems (CDSS) have significant value in aiding nurses and other medical personnel in making decisions by generating logical recommendations based on the most current evidence available to the system. Making use of algorithm-based decision alternatives, CDSS present opportunities for improving the quality of care available to patients (Liberati et al., 2017). CDSS leverages clinical knowledge management as a tool for managing both internal and external knowledge. Nursing Informatics – Clinical Decision Support System . It transforms the large amounts of medical data into relevant clinical information (McGonigle & Mastrian, 2018). The present paper offers an annotated bibliography of four journal articles that explore the potential for using CDSS to improve the quality of nursing care services.

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Annotated Bibliography

Lytle, K., Short, N., Richesson, R., & Horvath, M. (2015). Clinical Decision Support for Nurses: A Fall Risk and Prevention Example. CIN: Computers, Informatics, Nursing, 33(12), 530-537.

CDSS have been identified through systematic reviews of health information technology outcomes as valuable tools for improving clinician adherence to practice trials. The article notes that CDSS has much value for nurses by offering many benefits to improve improving interprofessional communication, increased access to information concerning best practice, and consistent care quality. Electronics health records are identified as tools that are already in place and can be leveraged through the use of CDSS whereby the data contained in the records would become useful. In addition, the article notes that falls risk is a concern within the health care environment since it is the most frequently reported adverse event in hospitals. Given this awareness, the research study presented in the article sought to determine if the use of CDSS can improve fall risk identification and fall prevention as a quality improvement initiative. For that matter, a quality improvement project was applied with a focus on evaluating the pre-intervention and post-intervention data. The project was applied in 16 adult inpatient units. A review of the data revealed that fall risk assessment were improved while documentations of the care plans did not change. Still, some of the units reported significant decrease in documentation. Nursing Informatics – Clinical Decision Support System .Additionally, there were no significant changes in fall incidences following the intervention. The authors are credible individuals as indicated by their academic credentials showing that they each had PhD level of education. The authors have extensive education backgrounds in nursing and health care subjects, and are practicing medical personnel. The researchers have clearly presented the research methodology, thus making the research more objective and reducing opportunities for bias. The article is helpful in exploring the importance of investing in CDSS as a tool for improving nursing care quality in terms of improving documentation. It is useful for supporting recommendations for increasing investment in CDSS as a strategy for improving the quality of nursing care services.

Keenan, G. M., Lopez, K. D., Yao, Y., Sousa, V. E., Stifter, j., Febretti, A., Johnson, A., & Wilkie, D. (2017). Toward Meaningful Care Plan Clinical Decision Support: Feasibility and Effects of a Simulated Pilot Study. Nurs Res., 66(5), 388-398. Nursing Informatics – Clinical Decision Support System .https://doi.org/10.1097/NNR.0000000000000234

CDSS are information management tools that allow users to easily understand health data by turning it into actionable information. The article acknowledges that CDSS is important at the point of care as it helps nurses to make evidence-based decisions. While CDSS tools have significant potential, the market has many CDSS tools and it is unclear what the idealized tool should contain in its format in order to function as intended. Towards this end, the study sought to compare multiple CDSS formats, and evaluate them in terms of use by nurses as regards graph literacy and numeracy. Additionally, the study sought to determine how the form affects the care planning time and best practice of nurses within a simulated environment. To explore these ideas, the study conducted a literature review that explored ideas presented in other publications with similar sentiments. Applying a pilot study approach that engaged 60 nurses with different CDSS formats, the study determined that CDSS had a high adoption rate among nurses and reduced the time spent on care planning. High numeracy and graph literacy was identified as the best format. The study revealed that although CDSS improves the efficiency and effectiveness of care planning decisions among nurses, there is a need to ensure that the appropriate CDSS format is adopted. The information presented in the article is reliable as the methodology is well presented with the discussion exploring the links between the publications cited and findings reported. Seven of the authors have PhD level of education while one author has master’s level of education but is a PhD student. These academic credentials show that the authors can be trusted to conduct and present a credible research study, thereby indicating that the article is an objective source of information. Nursing Informatics – Clinical Decision Support System . The article is helpful in exploring the importance of investing in the right CDSS as a tool for improving nursing care quality in terms of improving documentation. It is useful for supporting recommendations for increasing investment in CDSS as a strategy for improving the quality of nursing care services.

Jia, P., Zhang, L., Chen, J., Zhao, P., & Zhang, M. (2016). The Effects of Clinical Decision Support Systems on Medication Safety: An Overview. PLoS ONE, 11(12), e0167683. https://doi.org/10.1371/journal.pone.0167683

CDSS is identified as an important tool for facilitating decision making efforts. Incidentally, CDSS is capable of improving patient safety, specifically improving medication safety. However, a review of other publications presents conflicting results, thus making it uncertain whether implementing a CDSS would improve patient safety. As such, the research study sought to evaluate the effects of CDSS on patient safety, specifically medication safety, and if the research methodology and reporting quality had an effect on findings thereby explaining the conflicting effects of CDSS reported in other publications. Towards this end, the study applied a secondary research approach that involved reviewed publications from PubMed, Embase and Cochrane Library. The publications were on the effects of CDSS on medication safety. The results revealed that CDSS significantly impacts the care process in 75% of the publications. Evidence of CDSS positively impacting patient outcomes was reported in 20% of the publications. The research study determined that CDSS improves the patient outcomes and care process to include reducing medication errors. Still, it is noted that the results are inconsistent with a need for a more definitive study with larger samples running for a longer time in order to present more reliable evidence. Nursing Informatics – Clinical Decision Support System .The information presented in the article is reliable since it is based on other publications with the review being supported by clear evidence. The authors’ professional backgrounds show that they are credible since they are engaged in the health care industry. The article is objective and non-biased as it is based on previously published literature sources thus showing that extensive sources of information are explored to synthesize the presented opinions. The article is helpful in exploring the importance of investing in CDSS as a tool for improving nursing care quality in terms of improving patient safety. It is useful for supporting recommendations for increasing investment in CDSS as a strategy for improving the quality of nursing care services.

Lopez, K. D., Gephart, S. M., Raszewaski, R., Sousa, V., Shehorn, L. E., & Abraham, J. (2017). Integrative review of clinical decision support for registered nurses in acute care settings. JAMIA: Journal of the American Medical Informatics Association, 24(2), 441-450. https://doi.org/10.1093/jamia/ocw084

The health care environment is fast paced thereby creating opportunities for errors. Health information technologies intervene by allowing for fast responses in terms of decision making while reducing the opportunities for errors. The presence of CDSS acts as an important health information technology that guides medical personnel in making decisions. Given this awareness, the study sought to explore the importance of CDSS in supporting nurses to make the right care decisions. This was done by reviewing literature collected through searches in PubMed, Embase, CINAHL, Scopus, Web of Science, and IEEE Xplore. The search results identified 28 publications that met the inclusion criteria. The study reveals that CDSS is used to serve a range of functions that include 36% being used to support diagnostic decision making. 32% being used to ensure adherence to guidelines, 29% being used for medication management, and 25% being used to ensure situational awareness. Nursing Informatics – Clinical Decision Support System . In addition, the study noted that there are no negative effects associated with CDSS as concerns the process, usability and patient outcomes. The results of the study reveal that CDSS has a positive effect on nursing care outcomes and has the potential for improving care quality. The article is objective and non-biased as the methodology is well presented, showing how information was acquired and analyzed thereby allowing for replication. The article is helpful in exploring the importance of investing in CDSS as a tool for improving nursing care quality. It is useful for supporting recommendations for increasing investment in CDSS as a strategy for improving the quality of nursing care services.

Conclusion

CDSS is increasingly being adopted as a tool for supporting medical personnel in making the right decisions. It acts as a tool for managing information so that decisions are supported with evidence. A review of the four journal articles helps in exploring the idea that CDSS can be applied to improve the quality of nursing care services. Firstly, Lytle et al. (2015) reveals that CDSS is important for improving documentation thus helping with efforts to improve fall risk identification and fall prevention. Secondly, Keenan et al. (2017) reveals that although CDSS improves the efficiency and effectiveness of care planning decisions among nurses, there is a need to ensure that the appropriate CDSS format is adopted. Thirdly, Jia et al. (2016) determined that CDSS improves the patient outcomes and care process to include reducing medication errors. Finally, Lopez et al. (2017) study reveals that CDSS has a positive effect on nursing care outcomes and has the potential for improving care quality. The four articles are helpful in exploring the helpful in exploring the importance of investing in CDSS as a tool for improving nursing care quality. They are useful for supporting recommendations for increasing investment in CDSS as a strategy for improving the quality of nursing care services. Nursing Informatics – Clinical Decision Support System .

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References

Liberati, E., Ruggiero, F., Galuppo, L., Gorli, M., Gonzalez-Lorenzo, M., … & Moja, L. (2017). What hinders the uptake of computerized decision support systems in hospitals? A qualitative study and framework for implementation. Implementation Science, 12, Article 113. https://doi.org/10.1186/s13012-017-0644-2

Lytle, K., Short, N., Richesson, R., & Horvath, M. (2015). Clinical Decision Support for Nurses: A Fall Risk and Prevention Example. CIN: Computers, Informatics, Nursing, 33(12), 530-537.

McGonigle, D., & Mastrian, K. (2018). Nursing informatics and the foundation of knowledge (4^th ed.). Jones and Bartlett Learning. Nursing Informatics – Clinical Decision Support System.

Nursing Informatics – Clinical Decision Support System

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