DNP 805- Topic 3 Using CPOE and CDSS
DNP 805- Topic 3 Using CPOE and CDSS
DNP 805- Topic 3 Using CPOE and CDSS
CDSS is great at influencing the care delivery system positive as they improve the efficiency of the care processes by as they enhance all the safety measures that have been embedded in all the HIT tools being used by the HCP. The CDSS use the clinical information and the parameters that have been set or programmed to provide clinical-decision support to the HCP. The CDSS supports care decisions based on the standardized controlled data that is entered based on knowledge base and the reasoning capacity of the system and the communication output. Hence the frequently used adage of “garbage in- garbage out”. The CDSS would only make a decision based on what was programmed and what was entered as documentation. So, we have to require that all those who input information into the system are doing so accurately. To further patient safety, prevent delays with care (Alexander, Hoy, & Frith, 2019).
For example, in the area of patient registration for hospital admission. The emergency room registrar’s office has a habit of not updating the information in the records. We find that most patients do not have the correct address or phone number, or there is no emergency contact. Sometimes, in order to move forward, they enter the patient’s name as the emergency contact, which causes a problem when there is an emergency situation and the hospital cannot contact anyone because no one has come to see the patient or no one realized that there was no true emergency contact listed, and the worst part is that sometimes the listed emergent contact does not exist. The CDSS can help here if there is a trigger that forces them to enter new information rather than relying on old data. It will avoid the delays caused by attempting to find family members to consent to a procedure that is not an emergency.
When used for cardiovascular disease prevention, the CDSS can be used as a screening mechanism, reminding the
Utilizing CPOE and CDSS DNP 805
HCP to screen for certain risk factors and asking a series of questions about how they adhere to their medications, the type of treatments they have used, and recommendations for certain health behavior changes. For example, South Omaha Medical Associates (SOMA) has a high percentage of low-income patients in addition to clinics, so they conducted an assessment in collaboration with other health departments and realized that they needed to increase their use of EHR and implement CDSS. This has aided them in identifying patients with undiagnosed risk factors for cardiovascular disease. They increased their monitoring of quality measures and self-measuring of blood pressures by using CDSS, which improved their workflow and resulted in a 25% increase in patients coming to the clinic and improved patient safety outcomes (CDC, 2020).
References:
Alexander, S., Hoy, H., & Frith, K. (2019). Applied clinical informatics for nurses (2nd ed.). Jones & Bartlett Learning.
Centers for Disease Control and Prevention (CDC). (2020, July 7). How to implement clinical decision support systems. Centers for Disease Control and Prevention.
Details:
For this assignment, select one clinical practice issue that involves a specific medication. Using a Computerized Provider Order Entry (CPOE) system, design a Clinical Decision Support System (CDSS) that would be embedded in the EHR at your site of practice. Your CDSS must connect with CPOE to include a medication. You must link these two applications within the design.
Over the years, healthcare professionals have dealt with various conditions and illnesses that trouble individuals and
populations. While some of these illnesses onset occur 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.
General Guidelines:
Use the following information to ensure successful completion of the assignment:
- This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
- Doctoral learners are required to use APA style for their writing assignments. The APA Style Guide is located in the Student Success Center.
- Use primary sources published within the last 5 years. Provide citations and references for all sources used.
- You are required to submit this assignment to Turnitin. Refer to the directions in the Student Success Center.
Directions:
Write a 1,000-1,250 word paper that provides the following:
- Specific details of the clinical issue involving a specific medication
- The rationale behind your design development.
- A description of how this CDSS will be implemented and adopted by fellow clinicians.
- An assessment of challenges and proposed solutions which might apply to this scenario (e.g., information loss, communication breakdown).
Portfolio Practice Hours:
It may be possible to earn portfolio practice hours for this case report. Enter the following after the references section of your paper:
Practice Hours Completion Statement DNP-805
I, (INSERT NAME), verify that I have completed (NUMBER OF) clock hours in association with the goals and objectives for this assignment. I have also tracked said practice hours in the Typhon Student Tracking System for verification purposes and will be sure that all approvals are in place from my faculty and practice mentor
Rubric Criteria
Criterion | 1. Unsatisfactory | 2. Less Than Satisfactory | 3. Satisfactory | 4. Good | 5. Excellent |
|---|---|---|---|---|---|
Proposed CDSS Embedded in the EHR Proposed CDSS Embedded in the EHR | 0 points Proposed CDSS is not embedded in the EHR. | 12 points Proposed CDSS is embedded in the EHR but use is marginal or incomplete. | 13.2 points Proposed CDSS is embedded in the EHR but at a perfunctory level. | 13.8 points Proposed CDSS is embedded in the EHR in full. Discussion is convincing and defines specific elements. Information presented is from scholarly though dated sources. | 15 points Proposed CDSS is embedded in the EHR in full. Discussion is convincing and defines specific elements. Discussion is insightful and forward-thinking. Information presented is from current scholarly sources. |
Paper Format (Use of appropriate style for the major and assignment) Paper Format (Use of appropriate style for the major and assignment) | 0 points Template is not used appropriately or documentation format is rarely followed correctly. | 4 points Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent. | 4.4 points Template is used, and formatting is correct, although some minor errors may be present. | 4.6 points Template is fully used; There are virtually no errors in formatting style. | 5 points All format elements are correct. |
Documentation of Sources Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style) | 0 points Sources are not documented. | 4 points Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors. | 4.4 points Sources are documented, as appropriate to assignment and style, although some formatting errors may be present. | 4.6 points Sources are documented, as appropriate to assignment and style, and format is mostly correct. | 5 points Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error. |
Thesis Development and Purpose Thesis Development and Purpose | 0 points Paper lacks any discernible overall purpose or organizing claim. | 5.6 points Thesis is insufficiently developed or vague. Purpose is not clear. | 6.16 points Thesis is apparent and appropriate to purpose. | 6.44 points Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose. | 7 points Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear. |
Discussion of Specific Details of Clinical Issue Involving the Selected Medication Discussion of Specific Details of Clinical Issue Involving the Selected Medication | 0 points Discussion of specific details of the clinical issue involving the selected medication is not present. | 4 points Discussion of specific details of the clinical issue involving the selected medication is present but incomplete. | 4.4 points Discussion of specific details of the clinical issue involving the selected medication is present but rendered at a perfunctory level. | 4.6 points Discussion of specific details of the clinical issue involving the selected medication is convincing and thorough. Information presented is from scholarly though dated sources. | 5 points Discussion of specific details of the clinical issue involving the selected medication is convincing and thorough. Discussion is insightful and forward-thinking. Information presented is from current scholarly sources. |
Argument Logic and Construction Argument Logic and Construction | 0 points Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources. | 6.4 points Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility. | 7.04 points Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis. | 7.36 points Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative. | 8 points Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative. |
Description of How Proposed CDSS Will Be Implemented and Adopted by Fellow Clinicians Description of How Proposed CDSS Will Be Implemented and Adopted by Fellow Clinicians | 0 points A description of how the proposed CDSS will be implemented and adopted by fellow clinicians is not provided. | 8 points A description of how the proposed CDSS will be implemented and adopted by fellow clinicians is present but incomplete. | 8.8 points A description of how the proposed CDSS will be implemented and adopted by fellow clinicians is present but rendered at a perfunctory level. | 9.2 points A description of how the proposed CDSS will be implemented and adopted by fellow clinicians is present in full. Discussion is convincing and defines specific elements. Information presented is from scholarly though dated sources. | 10 points A description of how the proposed CDSS will be implemented and adopted by fellow clinicians is present in full. Discussion is convincing and defines specific elements. Discussion is insightful and forward-thinking. Information presented is from current scholarly sources. |
Proposed CDSS Design Links a Specific Medication Through the CPOE Proposed CDSS Design Links a Specific Medication Through the CPOE | 0 points Proposed CDSS design does not link a specific medication through the CPOE. | 4 points Proposed CDSS design links a specific medication through the CPOE but effort is marginal or incomplete. | 4.4 points Proposed CDSS design links a specific medication through the CPOE but at a perfunctory level. | 4.6 points Proposed CDSS design links a specific medication through the CPOE in full. Discussion is convincing and defines specific elements. Information presented is from scholarly though dated sources. | 5 points Proposed CDSS design links a specific medication through the CPOE in full. Discussion is convincing and defines specific elements. Discussion is insightful and forward-thinking. Information presented is from current scholarly sources. |
Mechanics of Writing (includes spelling, punctuation, grammar, language use) Mechanics of Writing (includes spelling, punctuation, grammar, language use) | 0 points Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used. | 4 points Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied. | 4.4 points Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed. | 4.6 points Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech. | 5 points Writer is clearly in command of standard, written, academic English. |
Assessment of Challenges and Proposed Solutions Which Might Apply to Scenario Assessment of Challenges and Proposed Solutions Which Might Apply to Scenario | 0 points An assessment of challenges and proposed solutions which might apply to this scenario is not provided. | 8 points An assessment of challenges and proposed solutions which might apply to this scenario is provided, but elements are missing or incomplete. | 8.8 points An assessment of challenges and proposed solutions which might apply to this scenario is provided, but the assessment is rendered at a perfunctory level. | 9.2 points An assessment of challenges and proposed solutions which might apply to this scenario is clearly presented and thorough. Discussion is convincing and defines specific elements. Information presented is from scholarly though dated sources. | 10 points An assessment of challenges and proposed solutions which might apply to this scenario is clearly presented and thorough. Discussion is insightful, forward-thinking, and detailed. Information presented is from current scholarly sources. |
Discussion of the Rationale Behind the Design Development Discussion of the Rationale Behind the Design Development | 0 points A discussion of the rationale behind the design development is not present. | 4 points A discussion of the rationale behind the design development is present but incomplete. | 4.4 points A discussion of the rationale behind the design development is present but rendered at a perfunctory level. | 4.6 points A discussion of the rationale behind the design development is convincing and defines specific elements. Information presented is from scholarly though dated sources. | 5 points A discussion of the rationale behind the design development is convincing and defines specific elements. Discussion is insightful and forward-thinking. Information presented is from current scholarly sources. |
Explanation of How Patient Outcomes Will Be Measured Explanation of How Patient Outcomes Will Be Measured | 0 points An explanation of how patient outcomes will be measured is not provided. | 4 points An explanation of how patient outcomes will be measured is provided but explanation is incomplete. | 4.4 points An explanation of how patient outcomes will be measured is provided at a perfunctory level. | 4.6 points An explanation of how patient outcomes will be measured is provided in full. Discussion is convincing and defines specific elements. Information presented is from scholarly though dated sources. | 5 points An explanation of how patient outcomes will be measured is provided in full. Discussion is convincing and defines specific elements. Discussion is insightful and forward-thinking. Information presented is from current scholarly sources. |
Computerized Provider Order Entry (CPOE) Used to Design a Clinical Decision Support System (CDSS)Com Computerized Provider Order Entry (CPOE) Used to Design a Clinical Decision Support System (CDSS) | 0 points CPOE is not used to design a CDSS. | 12 points CPOE is used to design a CDSS but use is marginal or incomplete. | 13.2 points CPOE is used to design a CDSS but used at a perfunctory level. | 13.8 points CPOE is used to design a CDSS in full. Discussion is convincing. Information presented is from scholarly though dated sources. | 15 points CPOE is used to design a CDSS in full. Discussion is insightful and forward-thinking. Information presented is from current scholarly sources. |