A Clinical Decision Support System Design Framework for Nursing Practice

Sheng-Chieh Lu,Martin Michalowski,Rebecca J Brown

doi:10.1055/s-0041-1736470

Abstract

AbstractBackground As nurses increasingly engage in decision-making for patients, a unique opportunity exists to translate research into practice using clinical decision support systems (CDSSs). While research has shown that CDSS has led to improvements in patient outcomes and nursing workflow, the success rate of CDSS implementation in nursing is low. Further, the majority of CDSS for nursing are not designed to support the care of patients with comorbidity.Objectives The aim of the study is to conceptualize an evidence-based CDSS supporting complex patient care for nursing.Methods We conceptualized the CDSS through extracting scientific findings of CDSS design and development. To describe the CDSS, we developed a conceptual framework comprising the key components of the CDSS and the relationships between the components. We instantiated the framework in the context of a hypothetical clinical case.Results We present the conceptualized CDSS with a framework comprising six interrelated components and demonstrate how each component is implemented via a hypothetical clinical case.Conclusion The proposed framework provides a common architecture for CDSS development and bridges CDSS research findings and development. Next research steps include (1) working with clinical nurses to identify their knowledge resources for a particular disease to better articulate the knowledge base needed by a CDSS, (2) develop and deploy a CDSS in practice using the framework, and (3) evaluate the CDSS in the context of nursing care.

Highlights

As nurses increasingly engage in decision-making for patients, a unique opportunity exists to translate research into practice using clinical decision support systems (CDSSs)
The proposed framework provides a common architecture for CDSS development and bridges CDSS research findings and development
Research steps include (1) working with clinical nurses to identify their knowledge resources for a particular disease to better articulate the knowledge base needed by a CDSS, (2) develop and deploy a CDSS in practice using the framework, and (3) evaluate the CDSS in the context of nursing care

Summary

Introduction

As nurses increasingly engage in decision-making for patients, a unique opportunity exists to translate research into practice using clinical decision support systems (CDSSs). Clinical decision support systems (CDSSs) are linked to improvements in preventive services, ordering of clinical tests, medication prescription, and financial outcomes.[1,2,3] As nurses increasingly engage in decision-making for patients, utilization of CDSSs to support nursing becomes more prevalent internationally.[4,5,6] There is a unique opportunity in nursing to translate research into practice using CDSSs because nursing interventions are often (a) inexpensive and (b) can be implemented with less administrative burden as nursing interventions are not linked to a prescription, international classification of diseases codes (ICD), or current procedural terminology code.[7,8] received December 10, 2020 accepted after revision September 2, 2021. Another notable barrier to implementation is lack of CDSSs that have a capability to support complex patient care[4,9]

Objectives

Methods

Results

Discussion

Conclusion