NURS 6421 week 2 Assignment Essay
Clinical Decision Support (CDS) System
Clinical Decision Support (CDS) system is considered an important element to healthcare to promote and maintain safety to patient care while providing care. This week’s discussion will include a brief summary of the CDS system highlighted in the article selected, including the practice setting in which it can be or was used and the requirements and guidelines that influenced its design. The discussion will also include the benefits of the CDS system to the practice setting and will identify the potential problems that could or did arise related to the CDS system.NURS 6421 week 2 Assignment Essay
Clinical Decision Support (CDS) System
Clinical Decision Support (CDS) is defined as “providing clinicians or patients with clinical knowledge and patient-related information, intelligently filtered or presented at appropriate times, to enhance patient care” (Brokel, 2009). Creating a culture of safety that is blame free is important prevent future errors (McGonigle, & Mastrian, 2018). CDS is considered as one of the essential tools for healthcare providers since the volume of data increases with the responsibility of delivering value-based care.
Article
Citation: – Carver, K. H., Burgess, L. H., Cooper, M., Elders, T., & Kramer, J. (2018). Use of clinical decision support to identify i.v.-to-oral conversion opportunities and cost savings. American Journal of Health-System Pharmacy, 75(23), S82-S86. https://doi-org.ezp.waldenulibrary.org/10.2146/ajhp170405
Medical errors being a common happening in the healthcare field, an article was chosen that used a CDS system to prevent the medication administration errors. The article was the study that included 149 hospitals that used CDS generated data to evaluate the timeliness of i.v-to-oral conversion practices relative to their impact on drug costs in a large health system over a six-month period (Carver, Burgess, Cooper, Elders, & Kramer, 2018). The CDS tool created alerts for i.v-to-oral conversions and was subsequently queued for review by a hospital pharmacist and then be approved or rejected per the need. The implementation of this CDS tool was beneficial to patients and the facilities by the meaningful use of resources to deliver care.NURS 6421 week 2 Assignment Essay
Benefits
CDS systems include several benefits to end users, patients, and healthcare workers. The main one is promotion of safety. The Health Information Technology for Economic and Clinical Health (HITECH) mandated the physicians to use electronic health records for meaningful use, and CDS tools embedded in the electronic health records helped to promote patient safety and deliver safe efficient care to community. According to McGonigle, & Mastrian (2018), “integration of technology into the medication administration cycle promises to reduce the potential for human errors in the cycle by performing electronic checks and providing alerts to draw attention to potential errors”. The study conducted in the article above resulted in substantial cost savings to the health system and reduced the errors from the medication dosages (Carver, Burgess, Cooper, Elders, & Kramer, 2018).
Potential problems
Proper identification of patients diagnoses, medications and contraindications for oral therapy are essential aspects for a successful i.v-to-oral conversion program (Carver, Burgess, Cooper, Elders, & Kramer, 2018). A thorough assessment of these areas should be included in the CDS tool so only patients that meet the requirements will be converted. Fear of losing autonomy in delivering care is a concern among the providers. Also the person reviewing the conversion ultimately will be held responsible for the decisions made regarding the change in the medications (Forrest, Van Schooneveld, Kullar, Schulz, Duong, & Postelnick, 2014). Alarm fatigue due to nonactionable alerts, that would not need attention cab be also a concern. Too much alerts can lead to disregarding relevant alerts, so alerts need to be made minimal with CDS tool to reduce errors.
Conclusion
CDS is a sophisticated health IT component. CDS tools enhances decision-making in the clinical workflow, and impact improvements in quality, safety, efficiency, effectiveness of health care. Recognizing that a CDS deployment is not only a technical project, is an important component of success (Health Analytics, 2018). NURS 6421 week 2 Assignment Essay
References
Carver, K. H., Burgess, L. H., Cooper, M., Elders, T., & Kramer, J. (2018). Use of clinical
decision support to identify i.v.-to-oral conversion opportunities and cost savings. American Journal of Health-System Pharmacy, 75(23), S82-S86. https://doi-org.ezp.waldenulibrary.org/10.2146/ajhp170405
Brokel, J. M. (2009). Infusing clinical decision support interventions into electronic health
records. Urologic Nursing, 29(5), 345-352. Retrieved from the Walden Library databases.
Forrest, G. N., Van Schooneveld, T. V., Kullar, R., Schulz, L. T., & Postelnick, M. (2014). Use
of electronic health records and clinical decision support systems for antimicrobial stewardship. Clinical Infectious Diseases, 59(3), 122-133. https://doi.org/10.1093/cid/ciu565
Health Anaytics. (2018). Understanding the basics of clinical decision support systems.
Retrieved from: https://healthitanalytics.com/features/understanding-the-basics-of-clinical-decision-support-systems
McGonigle, D., & Mastrian, K. G. (2018). Nursing Informatics and the foundation of knowledge (Bina,
Interesting post. Like you stated CDS improves the effectiveness and quality of patient care. We do have a CDS system that alerts for vaccine documentation like pneumonia and also for flu. This helps to identify and alert the patients that have not received flu vaccination during flu seasons. An effective electronic health record implementation is an essential foundation for effective clinical decision support (Glaser, 2008). Creating structures to represent data and knowledge so that complex relations can be visualized, developing methods for data acquisition and presentation that avoid information overload, managing change so that information is optimized, and integrating information into work processes so it can be acted on when it has the greatest effect are some of the principles that help in developing a CDS tool that is integrated with the electronic health record (Hummel, 2013).NURS 6421 week 2 Assignment Essay
I have experienced some physicians shows no interest to the CDS tools that is integrated into the electronic health records. Some of the barriers that lead to this include efficiency, perception of usefulness, information content, user interface, and over-triggering (Heath, 2012). This concept has changed through the years. More evidence based theories will help increase the usage of CDS tools in providing care to the patients.
References
Glaser, J. (2008). Clinical decision support: The power behind the electronic health record.
Healthcare Financial Management, 62(7), 46-48, 50-51. Retrieved from the Walden Library databases.
Heath, S. (2012). Why EHR clinical decision support tools need more research. Retrieved from:
https://ehrintelligence.com/news/why-ehr-clinical-decision-support-tools-need-more-research
Hummel, J. (2013). Integrating clinical decision support tools into ambulatory care workflows
for improved outcomes and patient safety. Retrieved from: https://www.healthit.gov/sites/default/files/clinical-decision-support-0913.pdf
Merrinda,
Love reading your post with labor and delivery background. The CDS tools are real beneficial to the healthcare industry to prevent and avoid the errors that can happen. I agree with you about the importance of having hard stops in the electronic health records that will help in the prevention of human errors. Hard stops are always found useful that soft stops that can be easily overridden with suggestions (Bresnick, 2018).NURS 6421 week 2 Assignment Essay
Working as an OR analyst, waste documentation seemed very important to me. Most of the wasted implants are seen during ortho and neuro instrumentation surgeries. Most of these occurrences happen due to incorrect sizes. So more attention needs to be paid to component trailing prior to implantation of the final prosthesis in order to achieve more accurate sizing (Pfefferle, Dilisio, Patti, Fening, & Junko (2015). A few weeks ago with our upgrade in our electronic health record, we initiated a hard stop for the documentation of implant waste. All the nurses loved it, and also as analysts we were able to identify the need of the wasted implant to determine the billing part. Hoping this will help in cost savings for the OR department…
References
Bresnick, J.(2018). Hard stops in EHRs, clinical decision support can improve care. Health
Analytics. Retrieved from: https://healthitanalytics.com/news/hard-stops-in-ehrs-clinical-decision-support-can-improve-care
Pfefferle, K. J., Dilisio, M. F., Patti, B., Fening, S. D., & Junko, J. T. (2015). Transparency to
Reduce Surgical Implant Waste. Clinics in orthopedic surgery, 7(2), 207-10.
Dr.Wilkes,
Thank you for the response. If your question prompted me to look onto the drug classifications that is commonly used for i.v-to-oral conversions. I found an article that was published in 2014.
Citation: – Cyriac, J. M., & James, E. (2014). Switch over from intravenous to oral therapy: A concise overview. Journal of pharmacology & pharmacotherapeutics, 5(2), 83-7.
This article mentions that antibiotics, gastrointestinal agents, antifungals, and flouroquinolones was the main drug classifications that is used for the conversion methods. The reasoning explained for this, is that drugs with good bioavailability (60-90%) of these drug classifications.NURS 6421 week 2 Assignment Essay
The study I chose for this week’s discussion used the drugs like famotidine, pantoprazole and
Levofloxacin, metronidazole etc…
References
Carver, K. H., Burgess, L. H., Cooper, M., Elders, T., & Kramer, J. (2018). Use of clinical
decision support to identify i.v.-to-oral conversion opportunities and cost savings. American Journal of Health-System Pharmacy, 75(23), S82-S86. https://doi-org.ezp.waldenulibrary.org/10.2146/ajhp17040
Cyriac, J. M., & James, E. (2014). Switch over from intravenous to oral therapy: A concise
overview. Journal of pharmacology & pharmacotherapeutics, 5
(2), 83-7.NURS 6421 week 2 Assignment Essay