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Development and Application of a Nurse-Led Clinical Decision Support System for Safe Intravenous Medication
Fuling Zhang1,2, Wenjuan Yun3, Lili Qin1,2
1Nursing Department, Changzhou Second People's Hospital, Changzhou Medical Center, Nanjing Medical University, Changzhou, Jiangsu Province, China.
Applied Clinical Informatics
|May 6, 2026
Summary
A new clinical decision support tool (CDSS) significantly reduced intravenous medication errors by 56.8% and improved nurse satisfaction. This nurse-led system enhances infusion safety and efficiency.
Area of Science:
- Nursing Informatics
- Clinical Decision Support Systems
- Patient Safety
Background:
- Intravenous medication administration is a high-risk procedure prone to errors.
- Clinical practice guidelines are increasingly integrated into clinical decision support systems (CDSS).
- CDSS development must prioritize nurses as users, workflow integration, and user-friendly design.
Purpose of the Study:
- To design and develop a CDSS using the Data-Information-Knowledge-Wisdom (DIKW) model.
- To minimize intravenous infusion errors through real-time alerts and standardized workflows.
- To evaluate the impact of the CDSS on error rates, severity, nurse satisfaction, and efficiency.
Main Methods:
- A non-randomized trial comparing traditional practices (n=1,204) with a CDSS (n=1,207) in a tertiary hospital.
- The CDSS utilized 300 clinical rules and a personal digital assistant (PDA) interface.
- Outcomes measured included error rates, error severity, nurse satisfaction, and prescription processing time.
Main Results:
- The CDSS reduced medication errors by 56.8% (from 16.69% to 7.21%, P<0.001).
- Severe medication errors (Level 3-4) were eliminated.
- Nurse satisfaction improved (mean 69.1/85), and prescription processing time decreased by 41%.
Conclusions:
- The nurse-led CDSS significantly enhances infusion safety and efficiency.
- The system offers a scalable solution for medication administration.
- Future optimization may involve AI-driven predictive error detection.
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