Full Answer Section

. Van der Meulen, R. T., & Smeulers, M. (2020). The effect of a clinical decision support system on nurses’ adherence to guidelines for indwelling urinary catheter care: A systematic review. International Journal of Medical Informatics, 137, 104085.

This systematic review examines the effectiveness of CDSS in improving nurses’ adherence to best practices for indwelling urinary catheter care. The authors synthesize findings from multiple studies, concluding that CDSS, particularly those that provide real-time reminders and alerts, significantly increase compliance with evidence-based guidelines. The review highlights that a major barrier to quality care is not a lack of knowledge, but a failure to consistently apply that knowledge in a busy clinical environment. The CDSS acts as a cognitive aid, prompting nurses to perform necessary checks and interventions, such as assessing the continued need for a catheter. The authors suggest that this type of technology is a powerful tool for preventing hospital-acquired infections, which are a major patient safety concern and a key quality metric. This article provides robust evidence that CDSS can directly translate to improved patient safety outcomes by bridging the gap between clinical knowledge and consistent practice.

2. Wright, A., Poon, E. G., & Jha, A. K. (2018). Use of clinical decision support to improve medication safety: An analysis of inpatient systems. Journal of Patient Safety, 14(4), 211–217.

This study focuses on how CDSS specifically impacts medication safety, a critical area of nursing practice with high potential for error. The authors analyze data from inpatient settings and find that medication-related CDSS alerts, such as drug-drug interaction warnings and dosage recommendations, are effective in intercepting potential errors before they reach the patient. However, they also raise a crucial point about alert fatigue, noting that too many irrelevant or low-priority alerts can lead nurses to override them, which can result in missed critical warnings. This publication emphasizes that for CDSS to be truly effective, it must be thoughtfully designed to deliver only highly relevant and actionable information. It underscores the importance of a nurse informaticist’s role in configuring these systems to ensure they are helpful rather than a hindrance. The findings demonstrate that while the technology itself is beneficial, its design and implementation are paramount to its success in promoting medication safety.

3. Johnson, C. M., & Johnson, G. W. (2019). The application of clinical decision support systems for fall prevention in acute care settings: An integrative review. Applied Clinical Informatics, 10(2), 221–234.

Johnson and Johnson’s integrative review explores the use of CDSS in the prevention of patient falls in acute care. They identify several types of CDSS interventions, including automated fall risk assessments, patient-specific fall risk alerts, and recommendations for fall prevention strategies. The review concludes that CDSS can improve nurses’ adherence to fall prevention protocols and, in some cases, has been directly correlated with a reduction in fall rates. The authors highlight a key benefit of CDSS in this area: it helps standardize fall risk assessment across different shifts and care teams, ensuring a consistent approach to patient safety. The review also notes that effective CDSS for fall prevention integrates into the existing nursing workflow rather than adding to it, making it more likely to be used correctly and consistently. This source provides compelling evidence that CDSS can address a significant patient safety risk, thereby improving quality of care and reducing harm.