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. 2008 Jun;77(6):413-20.
doi: 10.1016/j.ijmedinf.2007.08.006. Epub 2007 Sep 29.

Integrating evidence into clinical information systems for nursing decision support

Suzanne Bakken  1 , Leanne M Currie, Nam-Ju Lee, W Dan Roberts, Sarah A Collins, James J Cimino
Affiliations

Integrating evidence into clinical information systems for nursing decision support

Suzanne Bakken et al. Int J Med Inform. 2008 Jun.

Abstract

Purpose: To illustrate approaches for providing decision support for evidence-based nursing practice through integration of evidence into clinical information systems (CISs) with examples from our experience at Columbia University Medical Center.

Organizing construct: Examples are organized according to three types of decision support functions: information management, focusing attention, and patient-specific consultation.

Methods: Three decision support tools that are integrated into three types of CISs are discussed: (1) infobuttons that provide context-specific access to digital sources of evidence; (2) automated Fall-Injury Risk Assessment; and (3) personal digital assistant-based screening reminders, screening assessments, and tailored documentation templates for the identification and management of obesity, depression, and tobacco cessation. The informatics infrastructure for implementing these decision support tools is described from the perspective of components identified in the published literature.

Conclusions: Efforts to facilitate application of evidence into nursing practice are unlikely to be successful unless the approaches used are integrated into the clinical workflow. Our approaches use a variety of informatics methods to integrate evidence into CISs as a mechanism for providing decision support for evidence-based practice in a manner consistent with nursing workflow.

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Figures

Figure 1
Figure 1
Infobuttons in the laboratory results and medication list in WebCIS.
Figure 2
Figure 2
Fall-Injury Risk Assessment instrument as implemented in WebCIS (Screens 1-3) and Eclipsys Sunrise Clinical Care (Screen 4).
Figure 3
Figure 3
Screen shots from PDA-based decision support system for tobacco cessation. Ask, Assess, Assist, and Arrange are components of the 5 A’s of smoking cessation. The fifth A, Advise, in which the smoker is advised of the importance of quitting prior to Assessing willingness to quit is not explicitly documented in the application.
See this image and copyright information in PMC

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