A Clinical Decision Support System Design Framework for Nursing Practice

Abstract

Background As nurses increasingly engage in decision-making for patients, a unique opportunity exists to translate research into practice using clinical decision support systems (CDSSs). While research has shown that CDSS has led to improvements in patient outcomes and nursing workflow, the success rate of CDSS implementation in nursing is low. Further, the majority of CDSS for nursing are not designed to support the care of patients with comorbidity. Objectives The aim of the study is to conceptualize an evidence-based CDSS supporting complex patient care for nursing. Methods We conceptualized the CDSS through extracting scientific findings of CDSS design and development. To describe the CDSS, we developed a conceptual framework comprising the key components of the CDSS and the relationships between the components. We instantiated the framework in the context of a hypothetical clinical case. Results We present the conceptualized CDSS with a framework comprising six interrelated components and demonstrate how each component is implemented via a hypothetical clinical case. Conclusion The proposed framework provides a common architecture for CDSS development and bridges CDSS research findings and development. Next research steps include (1) working with clinical nurses to identify their knowledge resources for a particular disease to better articulate the knowledge base needed by a CDSS, (2) develop and deploy a CDSS in practice using the framework, and (3) evaluate the CDSS in the context of nursing care.

Clinical Decision Support Systems for Brain Tumour Diagnosis and Prognosis: A Systematic Review

“…The systems’ frequent lack of transparency regarding how the output was achieved can be another reason why there is lack of user acceptance [ 27 ]. Another notable barrier to CDSS implementation is its inability to effectively support complex patient care [ 28 ]. The implementation of CDSS incurs initial costs, such as those associated with training, support, and maintenance.…”

Nurses' Utilization of Information Resources for Patient Care Tasks

“…Further research is needed across healthcare systems, in nonurban teaching institutions for external validation of these results and to use those findings toward creating a centralized, dynamic, and usable CDSS to support nursing practice. We are working toward this end by incorporating our findings into the CDSS design process 30 …”

Global Trends and Hotspots in Nursing Research on Decision Support Systems

“…1,4 Therefore, implementation and adoption of DSSs are recommended in nursing practice. 5 The practice of evidence-based care in nursing is important in improving conditions for patient-centered care and the quality of healthcare, increasing patient safety, reducing patients' length of stay in the hospital, and providing better patient outcomes and equal healthcare. 6 Decision support systems are approaches that ensure and support the use of evidence-based care.…”

“…In particular, the use of DSSs in the field of nursing continues to increase with the development of information technologies, because DSSs improve the safety and quality of patient care, improve patient care outcomes, and minimize medical errors 1,4 . Therefore, implementation and adoption of DSSs are recommended in nursing practice 5 …”