- 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.
Rational: The system come with a result (Alarm) from the analysis of data collected from the patient. This is reported as an alert to prevent the overseeing of this critical information.
Generalize treatments for a condition, overseeing secondary comorbidities or preferences.
Rational: As a computerize system the analysis of data could be general, not allowing for the inclusion of preferences of the patient or the inclusion of secondary conditions.
Recommendation on possible treatments
Rational: The analysis of data allows the system to provide recommendations on the direction of care.
Recommendations could be inaccurate or base on old evidence base information.
Rational: The recommendations could be outdated, as the system will require of multiple updates. This could affect the best options of care provided to the patient.
Prevent medical errors & medications cross interactions
Rational: CDS systems to monitor for and identify errors before they affect the patient can prevent injury and harm. (Borum, C., 2018).
Production of unhelpful alarms that overwhelm the practitioner.
Rational: The production of alarms is always a good factor that reminds you of important information but is also projects a negative side as it could alarm with unhelpful task. Having a high quantity of these alarms could create a sense of dismissal where we start to ignore them.
- 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!
The NP is called for a pain medication request for a patient that was just admitted. The RN states the patient came to the floor without any medication for pain, and normally takes Norco 5mg/325mg q2hrs for chronic back pain. This information was collected in the reconciliation of meds at the admission portion. As the NP analyze the information a popup alert prompts her to take a second look of the medication information. The alert recommends a change in the frequency of the medication. It also provides options of the possible correct frequencies for Norco prescriptions. CDSS can improve medication safety providing recommendations relating to dosing, administration frequencies, medication discontinuation and avoidance (Medic, G., et al., 2019). The NP after looking into his records, previous prescriptions and the standard prescription protocols for Norco, decides to prescribe 5mg/325mg q4hrs. Providing also a reasonable evidence base answers for changing the frequency of the medication, as by the standard protocols is prescribed q4 or q6hrs. Exceeding on this frequency parameter could lead to an over-dosage of the medication, which could lead to liver damage. The CDSS in this case prevented the ordering of a medication out of the frequency parameter that could directly harm the patient outcome. It directly influence the actions from the NP, as it created a moment to question the information provided by the patient. This allowed for the analysis and consideration of what’s normally prescribe under correct protocols.