Designing the User Interface of a Nitroglycerin Dose Titration Decision Support System: User-Centered Design Study.

Area of Science:

• Cardiovascular Nursing
• Clinical Decision Support Systems
• Human-Computer Interaction

Background:

• Manual titration of intravenous nitroglycerin for angina presents challenges, including risks of hypotension or inadequate pain relief.
• Clinical decision support systems (CDSSs) offer potential to aid nurses in nitroglycerin titration by predicting blood pressure changes.

Purpose of the Study:

• To design a user interface for a CDSS specifically for nitroglycerin dose titration, termed the Nitroglycerin Dose Titration Decision Support System (nitro DSS).

Main Methods:

• A user-centered design (UCD) approach was employed, starting with qualitative interviews to gather design specifications.
• Iterative usability testing with experienced nurses in coronary care units refined the prototype through three rounds.

Main Results:

• Four key design themes emerged: clear/consistent, vigilant, interoperable, and reliable.
• The final nitro DSS prototype featured blood pressure prediction monitoring, side effect reporting, and safety alerts for low systolic blood pressure.
• Nurses reported excellent usability and acceptability of the developed nitro DSS prototype.

Conclusions:

• A UCD approach successfully facilitated nurse collaboration in developing the nitro DSS user interface.
• The designed nitro DSS aims to support nurses' clinical decision-making during nitroglycerin titration.