Journal article
Toward Meaningful Care Plan Clinical Decision Support: Feasibility and Effects of a Simulated Pilot Study
Nursing research (New York), Vol.66(5), pp.388-398
09/2017
DOI: 10.1097/NNR.0000000000000234
PMCID: PMC5657586
PMID: 28858147
Abstract
Clinical decision support (CDS) tools-with easily understood and actionable information, at the point of care-are needed to help registered nurses (RNs) make evidence-based decisions. Not clear are the optimal formats of CDS tools. Thorough, preclinical testing is desirable to avoid costly errors associated with premature implementation in electronic health records.
The aims of this study were to determine feasibility of the protocol designed to compare multiple CDS formats and evaluate effects of numeracy and graph literacy on RN adoption of best practices and care planning time in a simulated environment.
In this pilot study, 60 RNs were randomly assigned to one of four CDS conditions (control, text, text + graph, and text + table) and asked to adjust the plan of care for two patient scenarios over three shifts. Fourteen best practices were identified for the two patients and sent as suggestions with evidence to the three CDS groups. Best practice adoption rates, care planning time, and their relationship to the RN's numeracy and graph literacy scores were assessed.
CDS groups had a higher adoption rate of best practices (p < .001) across all shifts and decreased care planning time in shifts 2 (p = .01) and 3 (p = .02) compared with the control group. Higher numeracy and graph literacy were associated with shorter care planning times under text + table (p = .05) and text + graph (p = .01) conditions. No significant differences were found between the three CDS groups on adoption rate and care planning time.
This pilot study shows the feasibility of our protocol. Findings show preliminary evidence that CDS improves the efficiency and effectiveness of care planning decisions and that the optimal format may depend on individual RN characteristics. We recommend a study with sufficient power to compare different CDS formats and assess the impact of potential covariates on adoption rates and care planning time.
Details
- Title: Subtitle
- Toward Meaningful Care Plan Clinical Decision Support: Feasibility and Effects of a Simulated Pilot Study
- Creators
- Gail M Keenan - University of Illinois ChicagoKaren Dunn Lopez - and Janet Stifter, PhD, RN, CPHQ, is the Director of Center for Care Innovation and Transformation, the American Organization of Nurse Executives (AONE), Chicago, Illinois. Alessandro Febretti, MS, is Predoctoral StudentYingwei Yao - University of Illinois ChicagoVanessa E C SousaJanet StifterAlessandro FebrettiAndrew Johnson - Health Systems ScienceDiana J Wilkie - Neurobehavioral Research (United States)
- Resource Type
- Journal article
- Publication Details
- Nursing research (New York), Vol.66(5), pp.388-398
- DOI
- 10.1097/NNR.0000000000000234
- PMID
- 28858147
- PMCID
- PMC5657586
- NLM abbreviation
- Nurs Res
- ISSN
- 0029-6562
- eISSN
- 1538-9847
- Grant note
- P30 NR010680 / NINR NIH HHS R01 NR012949 / NINR NIH HHS R01 HS015054 / AHRQ HHS
- Language
- English
- Date published
- 09/2017
- Academic Unit
- Nursing
- Record Identifier
- 9984370645102771
Metrics
12 Record Views