Analysis of an integrated clinical decision support system in nursing home clinical information systems

This descriptive study evaluated a clinical decision support system (CDSS) in three nursing homes. The CDSS included alerts for decline in condition, improvement in condition, constipation, dehydration, loss of skin integrity, weight loss, and weight gain. Frequencies of alerts and their triggers were counted, and Spearman's rank correlations were determined between active alert frequency and number of secondary diagnoses. The most frequent alerts were for dehydration and improvement in condition. One significant positive correlation existed between number of secondary diagnoses and weight gain alert frequencies in residents with cerebral vascular accident. Health care leaders face challenges constructing an implementation strategy that addresses usability, ensures accuracy, and guides users to critical information about residents.