The use of clinical decision support (CDS) tools for bedside nurses shows promise as a means to improve care, but research lags far behind that of physician use of CDS for decision-making, according to research published in the Journal of the American Medical Informatics Association.
Nurses often are seen as collectors of data rather than decision-makers, yet at the bedside, they do make decisions when assessing conditions such as patient deterioration, the authors note.
Based on a literature review of 28 studies, the authors also note a “clear need to increase the sophistication and rigor of the study designs.” One common problem was a lack of specific metrics to gauge the effects of CDS.
The CDS systems most commonly addressed issues such as nursing diagnostic support, medication management, improving situational awareness, guideline adherence and triage.
The review found significant improvements in 14 of 15 outcomes measured in 10 studies with such metrics. No negative effects were found on process, usability, or patient outcomes. Significant improvements also were found across CDS types, except for nursing diagnostic support.
Yet only seven studies covered CDS tools that were fully integrated with the electronic heath record system and used real-time patient data. Many of the CDS systems required nurses to input data manually.
The researchers note that all the CDS systems targeted single conditions, such as pressure ulcers or delirium, or processes, such as triage. Ohio State University, for instance, has designed the Stroke Prevention in Healthcare Delivery Environments (SPHERE) tool to aggregate and display data relevant to cardiovascular health together.
To learn more:
- read the abstract