Research and review at least four peer-reviewed articles on evidence-based practice applied in clinical decision support (CDS). Must be within 5 years.
Matrix attached
Develop a 10- to 12-slide PowerPoint presentation in which you present your research and data to support your clinical decision support (CDS) recommendation for quality improvement.
Based on your research, address the following in your presentation:
Synthesize your findings from your four articles, focusing on applicable models and/or theories relevant to CDS, quality improvement in your workplace, and on applicable evidence-based practice in nursing.
Recommend CDS or information to consider in clinical decision making and explain your rationale for the recommendation. Be specific.
Justify your recommendation. Be specific and provide examples.
Recommend how you would address possible limitations or challenges, including:
Explain how you would avoid alert fatigue.
Explain under what conditions you would allow an override to an alert.
Explain how you would monitor compliance.
Identify factors that might contribute to continuous overrides.
Justify conditions under which an override may be necessary.
Full Answer Section
Slide 3
Introduction
Clinical decision support (CDS) is a suite of tools and technologies that can be used to support healthcare professionals in making informed decisions about patient care. CDS can provide information and recommendations on a variety of topics, including diagnosis, treatment, and prevention.
CDS has the potential to improve quality of care by reducing the risk of medical errors, improving adherence to clinical guidelines, and increasing the use of evidence-based practice.
Slide 4
Synthesis of findings from peer-reviewed articles
I reviewed four peer-reviewed articles on evidence-based practice applied in CDS. The articles focused on a variety of topics, including:
- The use of CDS to improve medication safety
- The use of CDS to support evidence-based practice in nursing
- The use of CDS to improve quality of care for patients with chronic diseases
Models and/or theories relevant to CDS, quality improvement, and evidence-based practice in nursing
One model that is relevant to CDS is the sociotechnical systems (STS) model. The STS model emphasizes the importance of both the technical (CDS) and social (human) components of healthcare systems.
Another model that is relevant to CDS is the knowledge-to-action (KTA) framework. The KTA framework is a model for implementing evidence-based practice. It includes seven steps:
- Identify the knowledge gap
- Select and adapt knowledge
- Assess barriers and facilitators to implementation
- Select, tailor, and implement intervention strategies
- Monitor and evaluate the implementation process and outcomes
- Sustain the implementation
Applicable evidence-based practice in nursing
One example of evidence-based practice in nursing that can be supported by CDS is the use of clinical guidelines. Clinical guidelines are systematic reviews of the evidence that provide recommendations for best practice. CDS can be used to remind nurses of clinical guidelines and to provide them with point-of-care access to the guidelines.
Another example of evidence-based practice in nursing that can be supported by CDS is the use of standardized order sets. Standardized order sets are groups of orders that have been pre-approved by clinicians for specific conditions or procedures. CDS can be used to automatically generate standardized order sets, which can help to reduce errors and improve efficiency.
Slide 5
CDS recommendation
I recommend that our organization implement a CDS system that supports the use of clinical guidelines and standardized order sets for patients with chronic diseases.
Rationale for recommendation
Chronic diseases are the leading cause of death and disability in the United States. CDS can help to improve the quality of care for patients with chronic diseases by:
- Reducing the risk of medical errors
- Improving adherence to clinical guidelines
- Increasing the use of evidence-based practice
Slide 6
Justification for recommendation
The following are some examples of how CDS can be used to support the use of clinical guidelines and standardized order sets for patients with chronic diseases:
- CDS can be used to remind nurses of clinical guidelines for specific chronic diseases, such as diabetes or heart failure.
- CDS can be used to automatically generate standardized order sets for patients with chronic diseases.
- CDS can be used to provide nurses with point-of-care access to clinical guidelines and standardized order sets.
Slide 7
Addressing limitations and challenges
Alert fatigue
Alert fatigue is a condition in which healthcare professionals become desensitized to alerts from CDS systems.
To avoid alert fatigue, our organization should implement a CDS system that allows nurses to customize their alerts and to suppress alerts that are not relevant to their practice.
Overriding alerts
Under certain circumstances, nurses may need to override alerts from CDS systems. For example, a nurse may need to override an alert if it is based on outdated information or if it is not relevant to the patient's individual situation.
Our organization should develop a policy that outlines the conditions under which nurses are allowed to override alerts. The policy should also require nurses to document their rationale for overriding an alert.
Monitoring compliance
To monitor compliance with CDS alerts, our organization should generate reports on the number of alerts that are overridden and the reasons for overriding.
Continuous overrides
Factors that might contribute to continuous overrides include:
- Alert fatigue
- Lack of trust in the CDS system
- Lack of understanding of the CDS system
To reduce the risk of continuous overrides, our organization should provide nurses with training on the CDS system and should encourage them to provide feedback on the system.