| Primary Author: | Susan Cortez, RN, BSN, MBA/ HCM, PhD |
| Co-Principal Investigators/Collaborators: | Nancy Wells RN, DNSc, PhD |
| Organization: | Vanderbilt University Medical Center |
Abstract
Purpose
The research purpose was to measure the effect of active Clinical Decision Support (CDS) on oncology nurses’ use of evidence-based interventions for symptom control.
Background
Rates of oncology nursing evidence-based practice range from 41 to 50%, due, in part, to lack of quick and easy access to evidence-based interventions during nurse-patient interaction. Clinical Decision Support embedded within the electronic documentation system may address this barrier.
Materials & Methods
This design was a longitudinal cluster randomized study with 2 oncology infusion clinics in the intervention group and 2 in the control group. The study intervention was active CDS, in the form of drop down boxes for 4 common symptoms – constipation, diarrhea, fatigue, and pain. Education sessions on the Oncology Nursing Society’s “Putting Evidence Into Practice” evidence-based interventions were offered for all nurses. The research outcome was adherence to evidence-based interventions, obtained using manual record review. The sample observations, pulled from the enterprise data warehouse (EDW), were documented interventions for cancer-related symptoms. Two hundred observations were pulled at baseline, post-education, and post-intervention yielding a total sample of 600. Mixed model linear statistical analysis was used to test the difference in use of evidence-based interventions between the intervention and control groups for each sample cycle.
Results
Chai Square analysis showed no statistically significant differences between groups on nursing education or years of clinical experience (p > 0.05). The average rate of intervention adherence at baseline was 27% across both groups. After education, the average rate increased to 36.5% and then decreased to 26% following the CDS intervention. The mixed model analysis showed no interaction between the groups and sample cycle (F(df=2,593)= 1.37, p= .26), suggesting active CDS did not improve use of evidence-based interventions.
Conclusion
Active CDS did not alter the nurse’s use of evidence-based interventions compared to controls. Further investigation of active CDS with additional interactive strategies is warranted.
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The ISRN published this as received and with permission from the author(s).