Journal article
Integrative review of clinical decision support for registered nurses in acute care settings
Journal of the American Medical Informatics Association : JAMIA, Vol.24(2), pp.441-450
03/01/2017
DOI: 10.1093/jamia/ocw084
PMCID: PMC7651925
PMID: 27330074
Abstract
To report on the state of the science of clinical decision support (CDS) for hospital bedside nurses.
We performed an integrative review of qualitative and quantitative peer-reviewed original research studies using a structured search of PubMed, Embase, Cumulative Index to Nursing and Applied Health Literature (CINAHL), Scopus, Web of Science, and IEEE Xplore (Institute of Electrical and Electronics Engineers Xplore Digital Library). We included articles that reported on CDS targeting bedside nurses and excluded in stages based on rules for titles, abstracts, and full articles. We extracted research design and methods, CDS purpose, electronic health record integration, usability, and process and patient outcomes.
Our search yielded 3157 articles. After removing duplicates and applying exclusion rules, 28 articles met the inclusion criteria. The majority of studies were single-site, descriptive or qualitative (43%) or quasi-experimental (36%). There was only 1 randomized controlled trial. The purpose of most CDS was to support diagnostic decision-making (36%), guideline adherence (32%), medication management (29%), and situational awareness (25%). All the studies that included process outcomes (7) and usability outcomes (4) and also had analytic procedures to detect changes in outcomes demonstrated statistically significant improvements. Three of 4 studies that included patient outcomes and also had analytic procedures to detect change showed statistically significant improvements. No negative effects of CDS were found on process, usability, or patient outcomes.
Clinical support systems targeting bedside nurses have positive effects on outcomes and hold promise for improving care quality; however, this research is lagging behind studies of CDS targeting medical decision-making in both volume and level of evidence.
Details
- Title: Subtitle
- Integrative review of clinical decision support for registered nurses in acute care settings
- Creators
- Karen Dunn Lopez - University of Illinois at ChicagoSheila M Gephart - University of ArizonaRebecca Raszewski - University of Illinois at ChicagoVanessa Sousa - University of Illinois at ChicagoLauren E Shehorn - University of ArizonaJoanna Abraham - University of Illinois at Chicago
- Resource Type
- Journal article
- Publication Details
- Journal of the American Medical Informatics Association : JAMIA, Vol.24(2), pp.441-450
- DOI
- 10.1093/jamia/ocw084
- PMID
- 27330074
- PMCID
- PMC7651925
- ISSN
- 1067-5027
- eISSN
- 1527-974X
- Grant note
- K08 HS022908 / AHRQ HHS
- Language
- English
- Date published
- 03/01/2017
- Academic Unit
- Nursing
- Record Identifier
- 9984370644402771
Metrics
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