Registered nurses' use of computerised decision support in medication reviews

Area of Science:

• Nursing Informatics
• Clinical Pharmacy
• Health Services Research

Background:

• Medication reviews are crucial for optimizing patient safety and treatment efficacy.
• Computerized decision support systems (CDSS) offer potential to enhance medication review processes.
• The role of registered nurses (RNs) in medication reviews using CDSS requires further investigation.

Purpose of the Study:

• To explore the implications of RNs utilizing a CDSS during medication reviews.
• To assess the impact of CDSS on identifying drug-related problems (DRPs) and improving drug treatment quality.
• To understand RNs' perceptions of CDSS utility in medication management.

Main Methods:

• A quasi-experimental, one-group pre-test/post-test design was employed.
• 11 RNs conducted 54 medication reviews with CDSS support over six months.
• Outcome measures included DRPs identified by CDSS and RNs, RNs' views, and changes in drug treatment quality.

Main Results:

• The CDSS identified significantly more DRPs, including potential adverse drug reactions (ADRs), compared to RNs alone.
• RNs identified additional DRPs, such as non-adherence, beyond the CDSS scope.
• RNs found the CDSS beneficial and desired continued use; minor improvements in drug treatment quality were observed, with a decrease in renally excreted drug use in patients with reduced renal function.

Conclusions:

• RNs' use of CDSS in medication reviews is valuable for detecting potential ADRs and interactions.
• Further inter-professional collaboration and structured implementation procedures are necessary to significantly impact drug treatment quality outcomes.
• This study provides novel insights into the RN's role and the implications of CDSS in medication reviews.