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Clinical Decision Support Systems for Pressure Ulcer Management: Systematic Review.
Sabrina Magalhaes Araujo1, Paulino Sousa2,3, Inês Dutra4,5
1Medical Informatics, Faculty of Medicine and Faculty of Sciences, University of Porto, Porto, Portugal.
JMIR Medical Informatics
|October 16, 2020
Summary
Clinical decision support systems (CDSS) show limited evidence for improving nurses' pressure ulcer management. More research is needed to assess their long-term impact on clinical decision-making and patient outcomes.
Area of Science:
- Nursing Informatics
- Health Information Technology
- Clinical Decision Support
Background:
- Pressure ulcer management is complex, relying on nurse experience and scientific knowledge.
- Evidence-based practices and health information technologies, like clinical decision support systems (CDSS), are crucial for quality care.
- CDSS can potentially reduce errors and healthcare costs, but their widespread use needs more evaluation.
Purpose of the Study:
- To systematically review the effects of nurses using CDSS on clinical decision-making in pressure ulcer management.
Main Methods:
- A systematic review following PRISMA guidelines was conducted.
- Searched 5 electronic databases (MEDLINE, SCOPUS, Web of Science, Cochrane, CINAHL) in April 2019.
- Included studies on computerized CDSS in pressure ulcer care; assessed quality using the Mixed Methods Appraisal Tool.
Main Results:
- 16 articles published between 1995-2017 were included from 998 initial results.
- Most studies focused on CDSS for pressure ulcer prevention in inpatient settings.
- Systems assessed effects on decision-making, clinical outcomes, and factors influencing use and implementation success.
Conclusions:
- Current literature provides insufficient evidence on the effects of CDSS on nurses' decision-making for pressure ulcer management.
- No significant impact on nurses' knowledge was found within 6 months of CDSS integration.
- Clinical effects on pressure ulcer incidence/prevalence were limited, often non-statistically significant; further research with robust designs and long-term follow-up is recommended.
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