Clinical Decision Support And Evidence-Based Practice

Just as global positioning systems (GPS) provide drivers with directions, detours, alternative routes, and alerts, clinical decision support (CDS) systems provide health care professionals with guidance for important decisions related to patient care. CDS systems have many capabilities, such as synthesizing patient information, recommending diagnostic tests, presenting alerts for life-threatening conditions, suggesting options for treatment, and offering relevant evidence and best practices. However, like GPSs, CDS systems are not always perfect, and many of their design specifications and functionalities are still evolving. In particular, issues such as alert fatigue and the integration of evidence-based practice (EBP) resources and clinical guidelines are still developing for CDS systems.
 
In this Assignment (due this Thursday), you identify the established EBP databases and clinical guidelines for your specialization area. You also consider how to integrate these elements into a CDS system specific to your specialization area. In addition, you analyze the benefits and drawbacks of integrating EBP and clinical guidelines within specialized CDS systems.
 
To prepare:
 

  • Review this week’s Learning Resources on CDS systems, EBP, and clinical guidelines. Focus on the Hammond, Jaffe, and Kush article, “Healthcare Standards Development: The Value of Nurturing Collaboration”(http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_043995.hcsp?dDocName=bok1_043995) and consider how CDS systems could be used to achieve integration of standards, guidelines, and EBP within your specialization area.
  • Identify at least two databases that can be considered “gold standards” for current research and EBP recommendations within your specialization area (Cardiology, I’m a cardiac nurse).
  • Identify at least two condition-specific clinical guidelines that are applicable to your specialization area. One possible resource for locating clinical guidelines is http://www.guidelines.gov
  • Consider how the databases and guidelines you identified could be integrated into a CDS system. For example, would you recommend an alert system, a side panel within an electronic health record (EHR) system, a separate computer or device for health care professionals to consult at their discretion, or an alternative system?
  • Reflect on the benefits and disadvantages of the type of CDS system you selected to integrate your EBP databases and clinical guidelines.

 
To complete:
 
Write a 3-page paper in APA format, due on Thursday 9/15/16, that addresses the following:
 

  1. Identify the two databases you selected as “gold standards” for EBP within your specialization area ( My specialization is Cardiac nursing ). Justify your selections.
  2. Identify the two condition-specific clinical guidelines you selected, and explain their significance within your specialization area. (http://www.guidelines.gov)
  3. Explain how the databases and guidelines you identified could be integrated into a CDS system. Describe the type of system you would recommend, and justify your recommendation.
  4. Identify at least two benefits and at least two challenges of the CDS system you recommended.
    Cite at least 4 references using APA style.
    This Assignment is due by Thursday 9/15/2016 by 12 noon
     
    Required Readings
    Bredemeyer, J., & Androwich, I. (2012). Transitional research: Generating evidence for practice. In D. McGonigle & K. G. Mastrian (Eds.), Nursing informatics and the foundation of knowledge (pp. 471–485). Burlington, MA: Jones and Bartlett.
    This chapter describes information gathering and application processes of translational research. The authors also identify the importance of self-critique and persistent answer-seeking in evidence-based practice.
     
    McGonigle, D., & Mastrian, K. G. (2015). Nursing informatics and the foundation of knowledge (3rd ed.). Burlington, MA: Jones and Bartlett Learning.

 

  • Chapter 25, “Translational Research: Generating Evidence for Practice”
  • Chapter 16, “Informatics Tools to Promote Patient Safety and Clinical Outcomes”

 
Ensuring the safety of patients is the responsibility of everyone within a health care organization. This chapter analyzes the role that technological advancements in information storage and delivery plays in supporting safety practices.
 
 
 
Brokel, J. M. (2009). Infusing clinical decision support interventions into electronic health records. Urologic Nursing, 29(5), 345–352.
 
Retrieved from the Walden Library databases.
 
This article describes a variety of decision support systems interventions that are available to nurses while using electronic health records. The author suggests how these interventions can be used by nurses for assessments, for diagnosing problems and identifying preferences, for performing interventions, and for evaluating outcomes.
 
 
 
Glaser, J. (2008). Clinical decision support: The power behind the electronic health record. Healthcare Financial Management, 62(7), 46–48, 50–51.
 
Retrieved from the Walden Library databases.
 
In this article, the author considers the impact that clinical decision support has on patient care by establishing the relationship between EHR-based patient care and CDS-based applications.
 
 
 
Kesselheim, A. S., Cressweel, K., Phansalkar, S., Bates, D. W., & Shiekh, A. (2011). Clinical decision support systems could be modified to reduce “alert fatigue” while still minimizing the risk of litigation. Health Affairs, 30(12), 2310–2317.
 
Retrieved from the Walden Library databases.
 
Clinical decision support (CDS) systems implemented to assist health care personnel with decision making help health care organizations use their resources most effectively. This article deals specifically with the ways CDSSs can help health care organizations save money.
 
 
 
Agency for Healthcare Research and Quality. (n.d.). National Guideline Clearinghouse. Retrieved January 2, 2014, from http://www.guideline.gov/
 
NGC is a public resource for evidence-based clinical practice guidelines. Provided by the Agency for Healthcare Research and Quality (AHRQ) a part of the U.S. Department of Health & Human Services.
 
 
 
 
 
Hammond, W. E., Jaffe, C., & Kush, R. D. (2009). Healthcare standards development: The value of nurturing collaboration. Journal of AHIMA, 80(7), 44–52. Retrieved from http://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_043995.hcsp?dDocName=bok1_043995
 
The authors examine how standards developing organizations (SDOs) collaborate to create technical standards. Those standards clarify communication between health care personnel and improve patient care.
 
 
 
 
 
McMaster University. (2012). Evidence-based practice resources. Retrieved from http://hsl.mcmaster.ca/resources/topic/eb/
 
This collection of resources on evidence-based practice (EBP) covers basic information about its methodologies. This includes a list of useful references, charts, and definitions pertaining to different facets of EBP application in health care organizations.

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I discourage over-utilization of direct quotes in DQs and assignments at the Master’s level and deduct points accordingly. As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content. It is best to paraphrase content and cite your source.

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