- 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.
- 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!
Adhere to the following guidelines regarding quality for the threaded discussions in Canvas:
- Application of Course Knowledge: Demonstrate the ability to analyze, synthesize, and/or apply principles and concepts learned in the course lesson and outside readings.
- Scholarliness and Scholarly Sources: Demonstrates achievement of scholarly inquiry for professional and academic decisions using valid, relevant, and reliable outside scholarly source to contribute to the discussion thread.
- Writing Mechanics: Grammar, spelling, syntax, and punctuation are accurate. In-text and reference citations should be formatted using correct APA guidelines.
- Direct Quotes: Good writing calls for the limited use of direct quotes. Direct quotes in discussions are to be limited to one short quotation (not to exceed 15 words). The quote must add substantively to the discussion. Points will be deducted under the grammar, syntax, APA category.
For each threaded discussion per week, the student will select no less than TWO scholarly sourcesto support the initial discussion post.
Clinical Decision Support Systems (CDSSs): Pros and Cons
| Pros (Benefits) | Cons (Drawbacks) |
|---|---|
| Improved Decision Making | Alert Fatigue |
| Enhanced Patient Safety | Data Privacy Concerns |
| Increased Efficiency | Over-Reliance on Technology |
Rationale for Pros:
- Improved Decision Making: CDSSs provide clinicians with evidence-based recommendations and guidelines, enabling them to make well-informed decisions that align with the latest medical knowledge.
- Enhanced Patient Safety: CDSSs can help identify potential medication errors, allergies, and adverse reactions, reducing the risk of harm to patients.
- Increased Efficiency: CDSSs streamline clinical workflows by automating tasks such as drug interactions checks and dosage calculations, leading to time savings and reduced administrative burden.
Rationale for Cons:
- Alert Fatigue: CDSSs may generate numerous alerts and notifications, leading to alert fatigue where clinicians start ignoring or overlooking important alerts due to their high volume.
- Data Privacy Concerns: CDSSs require access to patient data, raising concerns about data security, unauthorized access, and breaches of patient confidentiality.
- Over-Reliance on Technology: Excessive dependence on CDSSs might lead to clinicians relying solely on technology for decision-making, potentially undermining critical thinking and clinical judgment.
Clinical Scenario:
As an Advanced Practice Nurse (APN), imagine you are working in a busy outpatient clinic. You have a patient, Sarah, a 55-year-old woman with type 2 diabetes and hypertension. Sarah is currently on multiple medications, including an ACE inhibitor and a sulfonylurea. She presents with complaints of persistent fatigue and a recent increase in her blood pressure readings.
CDSS Influence on Decision-Making:
Using a CDSS, you input Sarah’s medical history, current medications, and recent symptoms. The CDSS analyzes this data and provides the following insights:
- Improved Decision Making: The CDSS suggests considering a possible drug interaction between the ACE inhibitor and the sulfonylurea, which could be contributing to Sarah’s fatigue and increased blood pressure. The recommendation is to assess alternatives and potentially adjust her medication regimen.
- Enhanced Patient Safety: The CDSS flags the potential interaction and recommends a comprehensive review of her medication list to ensure there are no other adverse effects or interactions that may compromise her safety.
- Increased Efficiency: The CDSS calculates the estimated glomerular filtration rate (eGFR) based on Sarah’s lab results and alerts you that her eGFR is lower than expected. This prompts you to consider adjusting the ACE inhibitor dose to prevent further kidney function decline.
In this scenario, the CDSS provides valuable insights, allowing you to make evidence-based decisions that address Sarah’s health concerns. However, you also recognize the importance of critically evaluating the CDSS recommendations and incorporating your clinical judgment to provide comprehensive and personalized care for Sarah.
Scholarly Sources:
- Smith, M., Saunders, R., Stuckhardt, L., & McGinnis, J. M. (Eds.). (2013). Best Care at Lower Cost: The Path to Continuously Learning Health Care in America. National Academies Press.
- Bates, D. W., Kuperman, G. J., & Wang, S. (2003). Ten commandments for effective clinical decision support: making the practice of evidence-based medicine a reality. Journal of the American Medical Informatics Association, 10(6), 523-530.