Authors: Sousa, V. E. C., Dunn Lopez, K.,, Febretti, A,, Stifter, J., Yao, Y., Johnson, A., Wilkie, D. J., Keenan, G. M.

Publication: CIN: Computers, Informatics, Nursing, vol 33, no 10, pp. 465–472

URL: https://doi.org/10.1097/CIN.0000000000000185

Our long-term goal is to ensure nurse clinical decision support (CDS) works as intended before full deployment in clinical practice. As part of a broader effort, this pilot explores factors influencing acceptance/non-acceptance of 8 CDS suggestions displayed through selecting a blinking red button in an electronic health record (EHR) based nursing plan of care software prototype. A diverse sample of 21 nurses participated in this high fidelity clinical simulation experience and completed a questionnaire to assess reasons for accepting/not accepting the CDS suggestions. Of 168 total suggestions displayed during the experiment (8 for each of the 21 nurses), 123 (73.2%) were accepted and 45 (26.8%) were not accepted. The mode number of acceptances by nurses was 7 of 8 with only 2 of 21 nurses accepting all. The main reason for CDS acceptance was the nurse’s belief that the suggestions were good for the patient (n=100%) with other features being secondarily reinforcing. Reasons for non-acceptance were less clear, with under half of the subjects indicating low confidence in the evidence. This study provides preliminary evidence that high-quality simulation and targeted questionnaires about specific CDS selections offer a cost-effective means for testing before full deployment in clinical practice.

Keywords: electronic health records; nursing care plans; standardization; clinical decision support systems; simulation lab

Date: October 1, 2015

Document: View PDF

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• Andrew Johnson
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• Hands-on Automated Nursing Data System (HANDS)

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