Review the Resources and reflect on the impact of clinical systems on outcomes and efficiencies within the context of nursing practice and healthcare delivery.

The Use of Clinical Systems to Improve Outcomes and Efficiencies

Clinical systems help in the delivery of healthcare worldwide. The use of health information technology and evidence-based practices helps to improve outcomes in patients. Clinical systems can improve efficiency, identify at-risk patients, integrate patient medical history in one place, and are used for research. One such clinical system is the Clinical Decision Support System (CDSS). CDSS are programs that analyze information in electronic health records (EHRs) to assist healthcare providers in making clinical decisions. This paper will examine four research articles on the application of CDSS to improve patient outcomes and efficiency.

Annotated Bibliography

Taheri Moghadam, S., Sadoughi, F., Velayati, F., Ehsanzadeh, S. J., & Poursharif, S. (2021). The effects of clinical decision support system for prescribing medication on patient outcomes and physician practice performance: A systematic review and meta-analysis. BMC Medical Informatics and Decision Making, 21(1). https://doi.org/10.1186/s12911-020-01376-8

According to Taheri Moghadam et al. (2021), using CDSS for prescribing aims to improve patient outcomes and the practice performance of physicians. This study is a systematic review to evaluate the effects of using various CDSSs on patient outcomes and physician performance. The study was done by searching multiple databases, including Cochrane Library and PubMed. A meta-analysis was done based on the medication subgroups, the type of CDSS used, and the various categories of outcomes. Essentially, 45 previous studies were qualified for analysis based on the inclusion criteria. The study results revealed that CDSS was effective in prescribing various diseases and efficient for patients taking multiple medications. These diseases include diabetes, cardiovascular, respiratory, and mental diseases.

In diabetes, for instance, CDSS was effective as it reminded patients to comply with their medication by sending short message reminders. It was also helpful in ensuring missed doses were taken. The use of CDSS for managing patients with diabetes revealed an improvement in HBA1C levels.

In managing patients with cardiovascular disease, the prescription of prophylaxis for venous thromboembolism increased. Another study revealed that the incidence of discrepancy among physicians when prescribing thromboprophylaxis was reduced. This reduction resulted from the treatment recommendations offered by the use of CDSS. Other reviewed studies revealed that CDSS positively affected physicians’ performance when giving anti-inflammatory and lipid-lowering drugs for treatment. In another survey reviewed by Taheri Moghadam et al. (2021), CDSS positively affected patient adherence to medication.

Taheri Moghadam et al. (2021) found that, in some trials, the integration of CDSS and Electronic health records (EHR) led to a decrease in the prescription of antibiotics and macrolides. Subsequently, this minimized the misuse of antibiotics and reduced antibiotic resistance.

One study revealed that four patients needing urgent treatment had their treatment delayed in patients taking multiple medications. This showed that CDSS should be monitored and evaluated as the adverse effects can be fatal. Another study, however, showed that using CDSS in patients with multiple prescriptions can be beneficial. Better intervals for drug use and improved primary doses of medication evidenced this. For mental health patients, CDSS alerts reduce the risk of injury.

CDSS improved medication prescription by improving physician compliance with available medication recommendations. Accordingly, this resulted in a reduction in the side effects experienced by the patients.

Sutton, R. T., Pincock, D., Baumgart, D. C., Sadowski, D. C., Fedorak, R. N., & Kroeker, K. I. (2020). An overview of clinical decision support systems: benefits, risks, and strategies for success. NPJ digital medicine, 3, 17. https://doi.org/10.1038/s41746-020-0221-y

According to Sutton et al. (2020), one of the advantages of using CDSS is improved patient safety. One way this is achieved is by reducing medication errors. Drug-drug interactions are preventable and can often be fatal. Sutton et al. (2020) cite that up to 65% of inpatients are exposed to potentially harmful drug combinations. CDSS is usually integrated into computerized provider order entry (CPOE) systems and electronic health records (EHR). CPOEs have drug safety software that performs drug-drug interaction checks and helps prevent therapy duplication. Electronic drug dispensing systems (EDDS) help with prescribing, transcribing, dispensing, and administering med