Question

A nurse on the unit in an acute care hospital scans the bar codes of a patient’s wristband and the medication each time a medication is administered. On occasion an alert that the medication about to be administered is contra-indicated for the patient is shown.

Why is this scenario an example of clinical decision support?

Answer 1

High-acuity patients and surging patient volumes combine to make the emergency department (ED) a care setting with high variability and potential for medical error. The ED clinical team can be greatly helped by electronic health record (EHR) tools with embedded or add-on clinical decision support (CDS) that supports both patient safety as well as throughput efficiency to reduce such risks.

CDS can be facilitated by patient identifier wristbands are ideal for hospitals, clinics and even senior citizen homes. The hospital patient ID wristband contains a barcode, which can easily be scanned using a barcode scanner. The band provides important health care information such as: patient’s name, previous conditions, allergies, what type of medicine should be administered and medicine dosage. Hospitals which have started using such wristbands have noted that they eliminate the possibility of making medical errors and help nurses and doctors accurately keep track of a patient’s condition.

Key benefits of CDS are:

1) Reduces the risk of medication errors- CDS can give physicians and nurses easy and quick access to drug-specific dosing calculators, full drug monographs with age, weight, disease and renal adjustment dosing, and much more. Accurate medication information and dosing calculators, easily accessible within the clinical workflow, can provide a significant reduction in errors.

2) Reduce misdiagnoses- When the diagnosis is not immediately obvious during a care crisis, ED professionals can use differential diagnosis support tools as an aid to rapidly identify diagnostic possibilities.

3) Provide the entire care team with consistent, reliable information- CDS can provide access to article abstracts, but it often cannot provide the answers clinicians need at the point of care. By arming providers with trusted resources, it is less likely that unreliable information will be used in clinical decision-making.

4) Improve efficiency and patient throughput- CDS is most effective when it is built into the clinician’s workflow, which minimizes interruptions and dangerous distractions. It is also important for CDS to be incorporated into providers’ workflow in such a way that minimizes alert fatigue.

5) Access all information in one place- CDS systems can be continually updated and validated. The ability to access the most current medical resources in a central location eliminates the need for multiple logins or investment in additional resources.