NR 599 Week 5 Discussion: Clinical Decision Support Systems (CDSSs)
NR 599 Week 5 Discussion: Clinical Decision Support Systems (CDSSs)
Potential Benefits and Drawbacks to Clinical Decision Support Systems
ProsConsImproves healthcare providers’ decision-making processes in complex patient cases.The CDSS enhances healthcare delivery by facilitating clinical decision-making with targeted clinical knowledge, patient data, and other health information (Muhiyaddin et al., 2020). The CDSS is seen as a threat by primary care providers to their clinical autonomy.Clinicians are the users of the CDSS.Some perceive that the purpose of the system is to limit their autonomy, which leads to reluctance to use the CDSS or use it inappropriately (Muhiyaddin et al., 2020).Improves delivery of evidenced-based care by healthcare providers.The CDSS analyzes data within electronic health records (EHRs) and gives prompts and reminders to help health providers implement evidence-based clinical guidelines during patient care (Sutton et al., 2020). The CDSS can be very costly to adopt, maintain, and support.The CDSS requires high costs for technical maintenance of systems applications and databases that power the CDSS and continuous staff training (Sutton et al., 2020).Increases patient safety and reduces the rate of misdiagnosis.The CDSS has alerts that notify clinicians of potential adverse drug events that may occur with drugs prescribed to a patient, which reduces the incidences of adverse drug reactions (Muhiyaddin et al., 2020). It also has computerized clinical guidelines and diagnostic support that assist clinicians in making clinical diagnoses.CDSS is associated with alert fatigue and inappropriate alerts.The CDSS often give inconsequential alerts that physicians tend to disagree with or distrust (Muhiyaddin et al., 2020). The inappropriate alerts are linked with alert fatigue for clinicians.
Clinical Patient and Scenario
An 8-year-old boy is brought to the ED with difficulties in breathing, wheezing, and a history of cough. The ED physician suspects the child has asthma and performs a spirometry test which reveals a forced expiratory volume (FEV1) of 70%. The physician administers the child Albuterol and then performs a spirometry test again, which improves to 85%. The FEV1 results are recorded in the CDSS-integrated EHR, which suggests that the patient has Asthma. In addition, the CDSS suggests the physician prescribe a Short-acting beta-agonist since it is the recommended evidence-based treatment for asthma for this patient. After one week, the patient returns to the ED with complaints of worsening dyspnea and wheezing despite using an Albuterol inhaler daily. The CDSS will suggest stepping up treatment to a low-dose inhaled corticosteroid such as Beclomethasone. Evidence-based guidelines suggest that if a Short-acting beta-agonist is used for more than two days per week except during exercise, it is considered inadequate control.
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NR 599 Week 5 Discussion: Clinical Decision Support Systems (CDSSs) References
Muhiyaddin, R., Abd-Alrazaq, A. A., Househ, M., Alam, T., & Shah, Z. (2020). The Impact of Clinical Decision Support Systems (CDSS) on Physicians: A Scoping Review. Studies in health technology and informatics, pp. 272, 470–473. https://doi.org/10.3233/SHTI200597
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), 17. https://doi.org/10.1038/s41746-020-0221-y
Preparing the Assignment
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.
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.
