DNP 805 Using CPOE and CDSS

Sample Answer

Over the years, healthcare professionals have dealt with various conditions and illnesses that trouble individuals and populations. While some of these illnesses onset away from the hospital and thus require hospital admissions, some are developed while individuals have been admitted into the hospitals. One such condition is pressure ulcers.

Even though various strategies have been applied to prevent and manage pressure ulcers, the condition is still prevalent and impacts patients negatively (BoykoTatiana et al., 2018). In particular, the pain resulting from the wounds usually causes patients suffering, calling for better prevention and management of the same. In attempts to find better remedies, various stakeholders have turned to technological solutions.

For example, the use of Clinical Decision Support System (CDSS) and the Computer Provider Order Entry (CPOE) have particularly been used in supporting the medication administration for better pharmacological outcomes (Shahmoradi et al., 2021). Therefore, the purpose of this assignment is to formulate a CDSS using a CPOE to be integrated into the Electronic Health Records to support the management of pain among patients experiencing pressure ulcer

The CDSS Design and the Rationale Behind the Design

The Computer Provider Order Entry entails using a computer for medication order entries as well as storage of the orders digitally. The CPOE also enables the entry of other data such as a patient’s imaging data, diagnostic test results, laboratory test results, and discussions held between the professionals.

Traditionally, CDSS was majorly characterized by helping professionals make appropriate care and patient decisions. However, the current systems even allow for a display of an individual’s past status while supporting other evaluations and recommendations (Shahmoradi et al., 2021).

As such, the advantages of using CDSS can be tapped and fine-tuned to ensure that patients with pressure ulcers get better pain management hence improved outcomes.

The designed CDSS is to be composed of a computer algorithm created to gather the patient’s important information such as the existing medication, comorbidities, the patient’s skin condition, the degree of pain, age, and gender.

As part of the system, the system will be key in offering the clinicians the necessary support when deciding on the best medication to be given to the patient depending on the collected data. The core design of the system will also have definitions, queries, and access tables which help in matching an individual’s current health condition with what is in the electronic health record.

This system has been proposed to help eliminate possible medication errors and prevent possible adverse drug interactions when offering care to patients with pressure ulcers (Shahmoradi et al., 2021). The elimination of medication errors and avoidance of drug interactions is obtained by giving the information in a simple and easily understood form and format. The proposed system will also be formulated so that it can easily be integrated into the facility’s electronic health record system.

The Implementation of the System and its Adoption by Fellow Clinicians.
A good plan should be in place to enable a successful implementation of the designed system. As part of the plan, the staff will have to undergo a comprehensive education and training session. The content of the training will be tips on using the new system, the reasons why the facility needs the new system, the main features and the advantages of using it.

As such, a total period of two weeks will be set aside for training and testing the new system. The staff workflows and responsibilities are to be modified to ensure that every staff engaged in the management and care of the patients with pressure ulcers can easily log in to the system and check the status of any patient of concern.

Security is important when using such systems; therefore, anyone logging into the system will be required to undergo a one-step password authentication to only allow the right users. After logging in, the clinician then in feeds the current information, such as the pressure ulcer indicators, into the EHR, opens the CDSS, and reviews the treatment options available for the patient as information to the individual’s health information.

The clinician then makes an assisted decision on the best medication that can be administered to the patient. Such a decision is then followed by the use of a CPOE to make medication order. The clinician then reviews the medication information that appears on the resolution table to ensure that everything is aligned. If there are any adjustments to be carried out, the professional states such a reason through a drop-down selection.

Potential Challenges and Possible Solutions.

The use of the created CPOE-assisted CDSS system in the facility implies that the organization’s operations will have to undergo some changes and adjustments. Evidence has it that introducing a change process in any organization can come with various challenges.

One of the prime challenges is staff resistance to the change being introduced. Such resistance may stem from various reasons, including viewing the proposed change as bothersome, existing misconceptions regarding CPOE and CDSS, and possible fear of the unknown (Westerbeek et al., 2021).

Solving such a resistance to the proposed change is key as resistance is known to negatively impact the implementation process, which can also extend to the use of the implemented system. Offering a comprehensive education and training on the new system to the staff is one key strategy that can be used in solving resistance.

In such a training, the staff is given valid reasons why the facility needs the new CDSS system and what expected benefits would be experienced upon its implementation. The new system will be integrated into the electronic health system, which has been key in simplifying the work to help in enhancing patient care and outcomes too.

The problem of medication errors is not a secret in any patient care setting, and therefore, such incidences can be used to ensure that the staff buys into the idea of using the CDSS system to lower the incidence of medication errors. When the new system is used, there are high chances that the medication error incidences will greatly be reduced (Westerbeek et al., 2021).

The staff can also be trained on how to operate the new system to help do away with resistance caused by insufficient knowledge of how to operate the new system. Again, the staff also needs to be trained and informed on the integration of the new system into the already existing EHR system.

The other barrier is the fear of potential loss of autonomy (Westerbeek et al., 2021). The staff may resist the use of the new system due to the fear that the new system would snatch away their autonomy as the system does the work more accurately and promptly.

The implication is that with the new system in place, the best treatment regimen for the patients can be offered even without the clinician’s input. This barrier can be overcome by assuring the staff that the new CDSS system will only assist in reducing their workload. Hence they can put more energy into special areas of patient care to improve care outcomes.

Conclusion

The demand for better and more efficient patient care and services in the care setting has led to various inventions and innovations. CDSS and CPOE have been used for years to improve patient outcomes. However, a combination of these two technologies still presents genuine opportunities to exploit and ensure that patient outcome are better.

Therefore, a CPOE-assisted CDSS system has been proposed to improve the use of pain medications to enhance the management of pain among patients with pressure ulcers. This system can be embedded into the electronic health record system to improve care outcomes.

References

• BoykoTatiana, V., LongakerMichael, T., & YangGeorge, P. (2018). Review of the current management of pressure ulcers. Advances in Wound Care. https //doi.org/10.1089/wound.2016.0697
  
• Shahmoradi, L., Safdari, R., Ahmadi, H., & Zahmatkeshan, M. (2021). Clinical decision support systems-based interventions to improve medication outcomes A systematic literature review on features and effects. Medical Journal of the Islamic Republic of Iran, 35, 27. https //dx.doi.org/10.47176%2Fmjiri.35.27.
  
• Westerbeek, L., Ploegmakers, K. J., de Bruijn, G. J., Linn, A. J., van Weert, J. C., Daams, J. G., … & Medlock, S. (2021). Barriers and Facilitators Influencing Medication-Related CDSS Acceptance According to Clinicians A Systematic Review. International Journal of Medical Informatics, 104506. https //doi.org/10.1016/j.ijmedinf.2021.104506