Practitioner approaches to the integration of clinical decision support system technology in critical care.
OBJECTIVE
The aim of this study was to explore the experiences of nurses and physicians who use a clinical decision support system (CDSS) in the critical care area, focusing on clinicians' motives and values related to decisions to either use or not use this optional technology.


BACKGROUND
Information technology (IT) has been demonstrated to positively impact quality of patient care. Decision-support technology serves as an adjunct to, not as a replacement for, actual clinical decision making. Nurse administrators play an imperative role in the planning and implementation of IT projects and can benefit from understanding clinicians' affective considerations and approaches to the technology.


METHODS
This qualitative study used grounded theory methods. A total of 33 clinicians participated in in-depth structured interviews probing their professional concerns with how the technology is used. Data were analyzed using the constant comparative method.


RESULTS
Medical staff were frustrated by perceived lack of planning input before system implementation. Both nurse and physician cohort groups were dissatisfied with preimplementation education. Barriers to system use were identified in significant detail by the participants.


CONCLUSIONS
Both nurses and physicians should be involved in preimplementation planning and ongoing evaluation of CDSSs. There is a need for a systematic review or Cochrane meta-analysis describing the affective aspects of successful implementations of decisional technology in critical care, specifically from the perspective of nursing administrators.
Weber
Scott
S
University of Pittsburgh School of Nursing, Pittsburgh, PA 15261, USA. webersjm@pitt.edu
Crago
Elizabeth A
EA
Sherwood
Paula R
PR
Smith
Tara
T
D000328:Adult; D001291:Attitude of Health Personnel; D020000:Decision Support Systems, Clinical / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration* / Q000639:trends; D008297:Male; D008505:Medical Staff, Hospital / Q000592:standards*; D008875:Middle Aged; D009741:Nursing Staff, Hospital / Q000592:standards*; D009936:Organizational Innovation; D036301:Qualitative Research; D000078329:Workforce