Prototype to practice: Developing and testing a clinical decision support system for secondary stroke prevention in a veterans healthcare facility

Jane A. Anderson, Pamela Willson, Nancy J. Peterson, Chris Murphy, Thomas A. Kent

Research output: Contribution to journalArticle

13 Scopus citations

Abstract

A clinical decision support system that guides nurse practitioners and other healthcare providers in secondary stroke prevention was developed by a multidisciplinary team with funding received from the Veterans Health Administration Office of Nursing Services. This article presents alpha-testing results obtained while using an integrated model for clinical decision support system development that emphasizes end-user perspectives throughout the development process. Before-after and descriptive methods were utilized to evaluate functionality and usability of the prototype among a sample of multidisciplinary clinicians. The predominant functionality feature of the tool is automated prompting and documentation of secondary stroke prevention guidelines in the electronic medical record. Documentation of guidelines was compared among multidisciplinary providers (N = 15) using test case scenarios and two documentation systems, standard versus the prototype. Usability was evaluated with an investigator-developed questionnaire and one open-ended question. The prototype prompted a significant increase (P < .05) in provider documentation for six of 11 guidelines as compared with baseline documentation while using the standard system. Of a possible 56 points, usability was scored high (mean, 48.9 [SD, 6.8]). These results support that guideline prompting has been successfully engineered to produce a usable and useful clinical decision support system for secondary stroke prevention.

Original languageEnglish (US)
Pages (from-to)353-363
Number of pages11
JournalCIN - Computers Informatics Nursing
Volume28
Issue number6
DOIs
StatePublished - Nov 1 2010

Keywords

  • Advanced practice nursing
  • Clinical decision support systems
  • Electronic medical record
  • Evidence-based practice
  • Nursing
  • Secondary stroke prevention
  • Usability

ASJC Scopus subject areas

  • Health Informatics
  • Nursing (miscellaneous)

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