NURS 6421: Week 2: Clinical Decision Support Essay Assignment Paper

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NURS 6421: Week 2: Clinical Decision Support Essay Assignment Paper

NURS 6421: Supporting Workflow in Healthcare Systems | Week  2

In May, 2011, Deborah Kogan’s 4-year-old son Leo came down with a fever. When the fever lasted for several hours and Leo’s face started to look puffy, Deborah took him to the pediatrician, who tested Leo for strep throat and then sent him home. The strep test came back negative, but a few days later, according to his mother, Leo’s face had swelled to about twice its normal size. She posted a picture of Leo on Facebook, and within a few hours she started receiving comments from friends and acquaintances who thought Leo might have Kawasaki disease. Deborah rushed Leo to the hospital where doctors confirmed this diagnosis and treated Leo for the disease (NPR, 2012).

Although this story ended well and Leo made a full recovery, it highlights a major concern in health care. For medical conditions that are rare, emerging, or that share symptoms with other conditions, physicians or nurses run a risk of misdiagnosing or failing to diagnose a patient at all, as in Leo’s case. This has significant implications not only for patient outcomes, but also for health care organizations and the public’s faith in the health care system. Fortunately, there are many emerging health care technologies and clinical decision support (CDS) systems that can reduce the likelihood of misdiagnosis, patient injuries, liabilities, and other risks.

This week, you explore the use of CDS systems in health care practice settings.

Learning Objectives

Students will:

  • Analyze the requirements and guidelines that influence the design of clinical decision support (CDS) systems
  • Analyze the benefits and potential problems of CDS systems in health care practice settings

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

Bredemeyer, J., & Androwich, I. (2012). Transitional research: Generating evidence for practice. In D. McGonigle & K. G. Mastrian (Eds.), Nursing informatics and the foundation of knowledge (pp. 471–485). Burlington, MA: Jones and Bartlett.

This chapter describes information gathering and application processes of translational research. The authors also identify the importance of self-critique and persistent answer-seeking in evidence-based practice.

McGonigle, D., & Mastrian, K. G. (2018). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones and Bartlett Learning.

  • Chapter 23, “Translational Research: Generating Evidence for Practice”
  • Chapter 15, “Informatics Tools to Promote Patient Safety and Clinical Outcomes”Ensuring the safety of patients is the responsibility of everyone within a health care organization. This chapter analyzes the role that technological advancements in information storage and delivery plays in supporting safety practices.

Brokel, J. M. (2009). Infusing clinical decision support interventions into electronic health records. Urologic Nursing, 29(5), 345–352.

This article describes a variety of decision support systems interventions that are available to nurses while using electronic health records. The author suggests how these interventions can be used by nurses for assessments, for diagnosing problems and identifying preferences, for performing interventions, and for evaluating outcomes.

Glaser, J. (2008). Clinical decision support: The power behind the electronic health record. Healthcare Financial Management, 62(7), 46–48, 50–51.

In this article, the author considers the impact that clinical decision support has on patient care by establishing the relationship between EHR-based patient care and CDS-based applications.

Kesselheim, A. S., Cressweel, K., Phansalkar, S., Bates, D. W., & Shiekh, A. (2011). Clinical decision support systems could be modified to reduce “alert fatigue” while still minimizing the risk of litigation. Health Affairs, 30(12), 2310–2317.

Clinical decision support (CDS) systems implemented to assist health care personnel with decision making help health care organizations use their resources most effectively. This article deals specifically with the ways CDSSs can help health care organizations save money.

Agency for Healthcare Research and Quality. (n.d.). National Guideline Clearinghouse. Retrieved January 2, 2014, from http://www.guideline.gov/

NGC is a public resource for evidence-based clinical practice guidelines. Provided by the Agency for Healthcare Research and Quality (AHRQ) a part of the U.S. Department of Health & Human Services.

Hammond, W. E., Jaffe, C., & Kush, R. D. (2009). Healthcare standards development: The value of nurturing collaboration. Journal of AHIMA, 80(7), 44–52. Retrieved from http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_043995.hcsp?dDocName=bok1_043995

The authors examine how standards developing organizations (SDOs) collaborate to create technical standards. Those standards clarify communication between health care personnel and improve patient care.

McMaster University. (2018). Resources for evidence–based practice: About EBP. Retrieved from https://hslmcmaster.libguides.com/c.php?g=306765&p=2044668

This collection of resources on evidence-based practice (EBP) covers basic information about its methodologies. This includes a list of useful references, charts, and definitions pertaining to different facets of EBP application in health care organizations.

In this Discussion, you analyze the elements that can influence the design of a CDS system. You also assess the benefits of CDS and identify challenges that may occur in practice related to a CDS system.

To prepare:

  • Review the information in this week’s Learning Resources on CDS systems. Reflect on why and how these systems are used in health care organizations and specific practice settings.
  • Search in the Walden Library for an article on a specific CDS system that has recently been researched, implemented, or evaluated. The article you select must have a publication date within the past 3 years.
  • Consider the requirements and guidelines (meaningful use, evidence-based practice guidelines, organizational regulations, core measures, etc.) that influenced the design of the CDS system.
  • Reflect on the benefits of using this CDS system in a practice setting. Why would an organization implement this specific system? What organizational, legal, or practice-related needs or issues does the system address?
  • Reflect on the practice-related problems that the system caused or could cause. For example, do you see an issue with alert fatigue, with too few alerts, with override capabilities, or with some other aspect of the system?

By Day 3

Post a brief summary of the CDS system highlighted in the article you selected, including the practice setting in which it can be or was used and the requirements and guidelines that influenced its design. Explain the benefits of the CDS system to the practice setting. Identify potential problems that could or did arise related to the CDS system.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days. Provide any additional insights you may have on the benefits and potential problems of the CDS system they described. Then propose at least one way the system could be revised to address the potential issues.

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