Feb 23, 2024 Discussion: NR 599 Clinical Decision Support Systems
Discussion: NR 599 Clinical Decision Support Systems
Discussion: NR 599 Clinical Decision Support Systems
NR599 Nursing Informatics for Advanced Practice
The clinical decision support systems (CDSS) are computer-based programs that analyze data within EHRs and give prompts and reminders to help health care providers in implementing evidence-based clinical guidelines at the point of care. They are primarily utilized at the point-of-care, for providers to combine their knowledge with information or suggestions provided by the system (Sutton et al., 2020). It is aimed at improving healthcare delivery by facilitating medical decisions with targeted clinical knowledge, patient information, and other health information. The purpose of this assignment is to explore the pros and cons of the CDSS.
PROS
CONS
Promotes patient safety.The CDSS has alerts that inform the clinician of potential adverse drug events that may transpire with a particular drug prescribed to a patient.
Medication-related CDS tools also help to lower medication errors thus promoting patient safety.
The CDSS is seen as a threat to clinicians’ clinical autonomy.Clinicians feel threatened by the clinical reminders, which elicit fear that one is losing autonomy and freedom of choice in the presence of the CDSS (Khairat et al., 2018).
In addition, clinicians may develop the perception that the CDSS is meant to replace or degrade their clinical roles.
Lowers the rate of misdiagnosis.The CDSS includes computerized clinical guidelines and diagnostic support that help clinicians in making clinical diagnoses. Thus reduces the chances of misdiagnosing patients.
CDSS is expensive to adopt, maintain, and support.The expenses associated with purchasing and maintaining the CDSS locks out some facilities from adopting it.
Improves efficiency of patient care delivery.The CDSS analyzes data within the EHR. As a result, it provides prompts and reminders that assist health care providers in implementing evidence-based clinical guidelines at the point of care, thus improving efficiency in delivering care (Khairat et al., 2018).
The CDSS also offer accurate diagnosis and dosage, which saves time.
The CDSS is associated with alert fatigue.Not every alert made by CDSS is usually correct.
This means that clinicians might struggle with alert-related fatigue. Besides, there are always some possibilities of low-value prompts and alerts (Khairat et al., 2018).
Increased quality of care and enhanced health outcomes.The CDSS provides information on treatment protocols, prompts questions on medication adherence, and provides tailored recommendations for health behavior changes (Khairat et al., 2018).
This improves the quality of care provided to patients, especially, those with chronic illnesses and enhances their health outcomes.
Failure to detect medication errors.If the CDSS is not implemented correctly, it may fail to identify medication errors, which can puts patients at risk (Sutton et al., 2020).
Clinical Patient and Scenario
A male adult patient comes to the psychiatric clinic with a severely elevated mood and symptoms suggesting mania. The patient’s relative mentions that he usually gets episodes of severely elevated mood whereby he is overactive. However, these periods last for one to two weeks, and the patient gets into a depressed mood. The CDSS, in this case, will be used to ensure that the PMHNP has made the correct psychiatric diagnosis of Bipolar disorder through the computerized DSM V in the system, which will lower the possibility of a misdiagnosis. In addition, the CDSS automated clinical guidelines will be used to identify the recommended medications to prescribe to a patient based on his age and severity of psychiatric symptoms. The CDSS will influence the drug prescribed based on the potential adverse drug events that the system will alert the PMHNP for each drug option. The drug with the least side effects and greatest benefit will be selected for this patient.
References
Khairat, S., Marc, D., Crosby, W., & Al Sanousi, A. (2018). Reasons For Physicians Not Adopting Clinical Decision Support Systems: Critical Analysis. JMIR medical informatics, 6(2), e24. https://doi.org/10.2196/medinform.8912
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Sutton, R. T., Pincock, D., Baumgart, D. C., Sadowski, D. C., Fedorak, R. N., & Kroeker, K. I. (2020). An overview of clinical decision support systems: benefits, risks, and strategies for success. NPJ digital medicine, 3(1), 1-10. https://doi.org/10.1038/s41746-020-0221-y
Week 5 Discussion
Clinical Decision Support Systems
Purpose
The ideas and beliefs underpinning the discussions guide students through engaging dialogues as they achieve the desired learning outcomes/competencies associated with their course in a manner that empowers them to organize, integrate, apply and critically appraise their knowledge to their selected field of practice. The ebb and flow of a discussion is based upon the composition of student and faculty interaction in the quest for relevant scholarship.
Activity Learning Outcomes
Through this discussion, the student will demonstrate the ability to:
Contribute level-appropriate knowledge and experience to the topic in a discussion environment that models professional and social interaction (CO4)
Actively engage in the written ideas of others by carefully reading, researching, reflecting, and responding to the contributions of their peers and course faculty (CO5)
Due Date:
Students must post a minimum of two times in each graded discussion. The two posts in each individual discussion must be on separate days. Posting twice on two different days meets the minimum requirement however for full credit, the student must post at least three substantive posts on three different days. The student must provide an initial post to each graded discussion topic posted by the course instructor, by Wednesday, 11:59 p.m. MT of Week 5. Subsequent posts, including essential responses to peers, must occur no later than the Sunday, 11:59 p.m. MT at the end of Week 5. Students are expected to submit assignments by the time they are due. Threaded discussions are not considered assignments and are not part of the late assignment policy.
A 10% late penalty will be imposed for discussions posted after the deadline on Wednesday regardless of the number of days late. NOTHING will be accepted after 11:59pm MT on Sunday (i.e. student will receive an automatic 0).
Requirements:
Post a written response in the discussion forum to EACH threaded discussion topic:
This week we learned about the potential benefits and drawbacks to clinical decision support systems (CDSSs). Create a “Pros” versus “Cons” table with a column for “Pro” and a separate column for “Con”. Include at least 3 items for each column. Next to each item, provide a brief rationale as to why you included it on the respective list.
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The primary goal of a CDSS is to leverage data and the scientific evidence to help guide appropriate decision making. CDSSs directly assist the clinician in making decisions about specific patients. For this discussion thread post, you are to assume your future role as an APN and create a clinical patient and scenario to illustrate an exemplary depiction of how a CDSS might influence your decision. This post is an opportunity for you to be innovative, so have fun!
Adhere to the following guidelines regarding quality for the threaded discussions in Canvas:
Application of Course Knowledge: Demonstrate the ability to analyze, synthesize, and/or apply principles and concepts learned in the course lesson and outside readings.
Scholarliness and Scholarly Sources: Demonstrates achievement of scholarly inquiry for professional and academic decisions using valid, relevant, and reliable outside scholarly source to contribute to the discussion thread.
Writing Mechanics: Grammar, spelling, syntax, and punctuation are accurate. In-text and reference citations should be formatted using correct APA guidelines.
Direct Quotes: Good writing calls for the limited use of direct quotes. Direct quotes in discussions are to be limited to one short quotation (not to exceed 15 words). The quote must add substantively to the discussion. Points will be deducted under the grammar, syntax, APA category.
For each threaded discussion per week, the student will select no less than TWO scholarly sources to support the initial discussion post.
Scholarly Sources: Only scholarly sources are acceptable for citation and reference in this course. These include peer-reviewed publications, government reports, or sources written by a professional or scholar in the field. The textbooks and lessons are NOT considered to be outside scholarly sources. For the threaded discussions and reflection posts, reputable internet sources such as websites by government agencies (URL ends in .gov) and respected organizations (often ends in .org) can be counted as scholarly sources. The best outside scholarly source to use is a peer-reviewed nursing journal. You are encouraged to use the Chamberlain library and search one of the available databases for a peer-reviewed journal article. The following sources should not be used: Wikipedia, Wikis, or blogs. These websites are not considered scholarly as anyone can add to these. Please be aware that .com websites can vary in scholarship and quality. For example, the American Heart Association is a .com site with scholarship and quality. It is the responsibility of the student to determine the scholarship and quality of any .com site. Ask your instructor before using any site if you are unsure. Points will be deducted from the rubric if the site does not demonstrate scholarship or quality. Current outside scholarly sources must be published with the last 5 years. Instructor permission must be obtained BEFORE the assignment is due if using a source that is older than 5 years.
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