DNP 805 Topic 3 Assignment Using CPOE and CDSS

DNP 805 Topic 3 Assignment Using CPOE and CDSS

Grand Canyon University DNP 805 Topic 3 Assignment Using CPOE and CDSS-Step-By-Step Guide

 

This guide will demonstrate how to complete the DNP 805 Topic 3 Assignment Using CPOE and CDSS assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

 

How to Research and Prepare for DNP 805 Topic 3 Assignment Using CPOE and CDSS                                   

 

Whether one passes or fails an academic assignment such as the Grand Canyon University   DNP 805 Topic 3 Assignment Using CPOE and CDSS depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

 

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

 

How to Write the Introduction for DNP 805 Topic 3 Assignment Using CPOE and CDSS                                   

 

The introduction for the Grand Canyon University   DNP 805 Topic 3 Assignment Using CPOE and CDSS is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

 

How to Write the Body for DNP 805 Topic 3 Assignment Using CPOE and CDSS                                   

 

After the introduction, move into the main part of the DNP 805 Topic 3 Assignment Using CPOE and CDSS assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

 

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

 

How to Write the Conclusion for DNP 805 Topic 3 Assignment Using CPOE and CDSS                                   

 

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

 

How to Format the References List for DNP 805 Topic 3 Assignment Using CPOE and CDSS                                   

 

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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DNP 805 Topic 3 Assignment Using CPOE and CDSS

Computerized physician order entry (CPOE) is one of the most successful and critical healthcare technologies deployed today to enhance care provision. CPOE is a technology that allows medical providers to enter medication orders instead of using a handwritten paper format or system. CPOE is essential in reducing medication errors, enhancing efficiency and clinical decision-making (Jungreithmayr et al., 2021). Providers can integrate a clinical decision support system (CDSS) as a tool that incorporates installed clinical knowledge and patient information to enhance patient care, especially when dealing with the opioid epidemic (Sutton et al., 2020). The essence of this essay is to assess the ordering and prescribing of opioids using a CPOE system and design a CDSS that would be integrated into an electronic health record system (EHR). The paper also offers details of the clinical issue, the rationale behind the development of the system, and describes the implementation of CDSS.

Clinical Issue

Reports and studies show that over 100 lives are lost daily in the United States due to drug overdose (HealthIT.Gov., 2018). Bart et al. (2020) assert that the efficiency of opioids for pain management and drug-seeking effects of the opioid addicts is making providers prescribe over 200 million opioids each year. Some of the physicians do not have an idea that patients are selling or abusing these prescriptions. Studies show that close to 91% of those overdosing opioids continue to receive their supply of pills even after the incident (Sutton et al., 2020). The opioid epidemic is a critical public health issue that requires effective interventions, right from the physicians prescribing these medications because of their adverse effects on health populations and individuals, especially those abusing the drugs.

Physicians can leverage CPOE and CDSS to prevent drug overdose and medication errors. Clinical decision support systems intervene at prescribing level by giving alerts to warn providers of possible adverse drug effects. The CDSS also reduces errors. The need to integrate both CPOE and CDSS is essential in ensuring that physicians generate the right information to reduce susceptibility for individuals to abuse these medications (Farre et al., 2019). CPOE offers alerts to ordering physicians, pharmacists, and administering nurses on patient allergies, current medications, and dosing based on the right weight. However, ascertaining that the new electronic processes align with physicians’ workflow is a paradoxical task as many EHRs vendors are not willing to change or turn off the medication alerts functionalities because they fear exposure to more liability. The implication is that physicians have to navigate frequent warnings with minimal clinical significance.

Development of the Design

Multiple ideas exist on how providers and organizations can address the widespread opioid problem. One approach would be having new alerts within a facility’s EHRs triggered by chosen risks for abuse. The red flags may entail if a patient has a history of being in the outpatient department on an opioid or benzodiazepine, prescription for two drugs in the last 30 days and if they have tested positive for other substances like cocaine or marijuana in the last toxicology screening (Prgomet et al., 2017).The rationale is to package all relevant data in the EHRs and place it in physician’s access at the point of care. The physician does not have to dig through charts to generate information as they try to ensure that they attend to all patients while in a busy shift.

The foundation of developing the CDSS would be to establish a rule in the EHR system that recognizes patients at risk using searchable, unbiased gauges that can indicate the risk for abuse, misuse, and potential diversion of the prescribed opioids. The providers must leverage existing peer-reviewed information from literature and consensus opinions (Farre et al., 2019). The providers should use the information from this rule in an iterative improvement process to change the alert timing and the bare minimum or threshold for alerts to produce an adequate level of appropriate alerts at the point of care for effective decision making.

Implementation and Adoption of the CDSS

Implementing health information technology interventions in healthcare settings forms the priority of many policy agendas. Technology improvement processes are complicated undertakings and are always far from being straightforward. Implementation needs strategic planning based on systematic organizational changes linked to such programs (Srinivasamurthy et al., 2021). Any change to the workflow of healthcare providers brings frustrations and more work to ensure that the technology works to its full ability.

The first step in implementing the system would be an effective engagement of physicians and other critical care providers. Implementing this alert will require presentation to the pharmacy and physician committees to attain buy-in from the two critical stakeholders. The second step would be the integration of the CDSS with other quality improvement initiatives in the facility to align with the organization’s overall goal to enhance patient safety and quality of care (Scott et al., 2018). Through this approach, the new alert system will not significantly alter the physician workflow and help attain the desired aim. The approach will also ensure that the benefits of the CDSS are not assumed but evaluated based on the implemented system.

It is essential to have a detailed account of existing processes and initiatives before the implementation to reduce the risk of complications and help identify a current issue that this technology is designed to address (Bart et al., 2020). The CDSS strategy must align with the unique culture and practice of the organization for successful adoption and use of the technology. To attain successful implementation, the program must conduct a thorough assessment of possible barriers, like training for end and super users of the CDSS.

Challenges and Possible Solutions

The implementation of CDSS can have valuable benefits like enhancing patient care outcomes and ensuring that they do not abuse prescribed opioids. However, implementation challenges are bound. Emphasis on vital information that is clear, concise, and prompt leads to better adoption and increased positive effects. The alert triggers should be optimized to concentrate on the population of interest, disrupting workflows and physician concentration. Further, frequent alerts can lead to “alert fatigue,” making physicians and other providers ignore them, even in critical situations (Scott et al., 2018). Therefore, it is essential to validate and thoroughly test EHRs alerts to guarantee effective implementation through engagement and support from all stakeholders from the planning stage.

Conclusion

The deployment of clinical decision support systems (CDSS) through the integration of CPOE is critical to reducing medication errors and tackling the opioid crisis. The CDSS alerts clinicians to have correct treatment decisions. Well-designed CDSS and sufficient engagement and support from stakeholders like physicians and pharmacists are essential for successful implementation and ease of adoption among providers and organizations. Through these interventions, providers and stakeholders can mitigate and prevent the ever-rising opioid epidemic and its associated adverse effects on public health and individuals.

 

 

References

Bart, G. B., Saxon, A., Fiellin, D. A., McNeely, J., Muench, J. P., Shanahan, C. W., … & Gore-

Langton, R. E. (2020). Developing a clinical decision support for opioid use disorders: a NIDA center for the clinical trials network working group report.  Addiction Science & Clinical Practice, 15(4). https://doi.org/10.1186/s13722-020-0180-2

Farre, A., Heath, G., Shaw, K., Bem, D., & Cummins, C. (2019). How do stakeholders

experience the adoption of electronic prescribing systems in hospitals? A systematic review and thematic synthesis of qualitative studies. BMJ quality & safety, 28(12), 1021-1031. http://dx.doi.org/10.1136/bmjqs-2018-009082

HealthIT.Gov. (2018). Improving Opioid Prescribing through Electronic Clinical Decision

Support Tools. https://www.healthit.gov/sites/default/files/2018-12/CDSSession.pdf

Jungreithmayr, V., Meid, A. D., Haefeli, W. E., & Seidling, H. M. (2021). The impact of a

computerized physician order entry system implementation on 20 different criteria of medication documentation—a before-and-after study. BMC Medical Informatics and Decision Making, 21(1), 1-12. https://doi.org/10.1186/s12911-021-01607-6

Prgomet, M., Li, L., Niazkhani, Z., Georgiou, A., & Westbrook, J. I. (2017). Impact of

commercial computerized provider order entry (CPOE) and clinical decision support systems (CDSSs) on medication errors, length of stay, and mortality in intensive care units: a systematic review and meta-analysis. Journal of the American Medical Informatics Association, 24(2), 413-422. https://doi.org/10.1093/jamia/ocw145

Scott, I. A., Pillans, P. I., Barras, M., & Morris, C. (2018). Using EMR-enabled computerized

decision support systems to reduce prescribing of potentially inappropriate medications: a narrative review. Therapeutic advances in drug safety, 9(9), 559-573. https://doi.org/10.1177/2042098618784809

Srinivasamurthy, S. K., Ashokkumar, R., Kodidela, S., Howard, S. C., Samer, C. F., & Rao, U.

9. C. (2021). Impact of computerized physician order entry (CPOE) on the incidence of chemotherapy-related medication errors: a systematic review. European Journal of Clinical Pharmacology, 1-9. https://doi.org/10.1007/s00228-021-03099-9

Sutton, R. T., Pincock, D., Baumgart, D. C., Sadowski, D. C., Fedorak, R. N., & Kroeker, K. I.

(2020). An overview of clinical decision support systems: benefits, risks, and strategies for success. NPJ digital medicine, 3(1), 1-10. https://doi.org/10.1038/s41746-020-0221-y

Assessment Description

For this assignment, select one clinical practice issue that involves a specific medication. Using a Computerized Provider Order Entry (CPOE) system, design a Clinical Decision Support System (CDSS) that would be embedded in the EHR at your site of practice. Your CDSS must connect with CPOE to include a medication. You must link these two applications within the design.

General Guidelines:

Use the following information to ensure successful completion of the assignment:

• This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
• Use primary sources published within the last 5 years. Provide citations and references for all sources used.
• Doctoral learners are required to use APA style for their writing assignments. The APA Style Guide is located in the Student Success Center.
• You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
• Learners will submit this assignment using the assignment dropbox in the learning management system. In addition, learners must upload this deliverable to the Learner Dissertation Page (LDP) in the DNP PI Workspace for later use.

Directions:

Write a 1,000-1,250 word paper that provides the following:

1. Specific details of the clinical issue involving a specific medication
2. The rationale behind your design development.
3. A description of how this CDSS will be implemented and adopted by fellow clinicians.
4. An assessment of challenges and proposed solutions which might apply to this scenario (e.g., information loss, communication breakdown).

Using CPOE and CDSS – Rubric

Collapse All Using CPOE And CDSS – RubricCollapse All

Computerized Provider Order Entry (CPOE) Used to Design a Clinical Decision Support System (CDSS)Com

15 points

Criteria Description

Computerized Provider Order Entry (CPOE) Used to Design a Clinical Decision Support System (CDSS)

5. Excellent

15 points

CPOE is used to design a CDSS in full. Discussion is insightful and forward-thinking. Information presented is from current scholarly sources.

4. Good

13.8 points

CPOE is used to design a CDSS in full. Discussion is convincing. Information presented is from scholarly though dated sources.

3. Satisfactory

13.2 points

CPOE is used to design a CDSS but used at a perfunctory level.

2. Less Than Satisfactory

12 points

CPOE is used to design a CDSS but use is marginal or incomplete.

1. Unsatisfactory

0 points

CPOE is not used to design a CDSS.

Proposed CDSS Embedded in the EHR

15 points

Criteria Description

Proposed CDSS Embedded in the EHR

5. Excellent

15 points

Proposed CDSS is embedded in the EHR in full. Discussion is convincing and defines specific elements. Discussion is insightful and

forward-thinking. Information presented is from current scholarly sources.

4. Good

13.8 points

Proposed CDSS is embedded in the EHR in full. Discussion is convincing and defines specific elements. Information presented is from scholarly though dated sources.

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3. Satisfactory

13.2 points

Proposed CDSS is embedded in the EHR but at a perfunctory level.

2. Less Than Satisfactory

12 points

Proposed CDSS is embedded in the EHR but use is marginal or incomplete.

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1. Unsatisfactory

0 points

Proposed CDSS is not embedded in the EHR.

Proposed CDSS Design Links a Specific Medication Through the CPOE

5 points

Criteria Description

Proposed CDSS Design Links a Specific Medication Through the CPOE

5. Excellent

5 points

Proposed CDSS design links a specific medication through the CPOE in full. Discussion is convincing and defines specific elements. Discussion is insightful and forward-thinking. Information presented is from current scholarly sources.

4. Good

4.6 points

Proposed CDSS design links a specific medication through the CPOE in full. Discussion is convincing and defines specific elements. Information presented is from scholarly though dated sources.

3. Satisfactory

4.4 points

Proposed CDSS design links a specific medication through the CPOE but at a perfunctory level.

2. Less Than Satisfactory

4 points

Proposed CDSS design links a specific medication through the CPOE but effort is marginal or incomplete.

1. Unsatisfactory

0 points

Proposed CDSS design does not link a specific medication through the CPOE.

Discussion of Specific Details of Clinical Issue Involving the Selected Medication

5 points

Criteria Description

Discussion of Specific Details of Clinical Issue Involving the Selected Medication

5. Excellent

5 points

Discussion of specific details of the clinical issue involving the selected medication is convincing and thorough. Discussion is insightful and forward-thinking. Information presented is from current scholarly sources.

4. Good

4.6 points

Discussion of specific details of the clinical issue involving the selected medication is convincing and thorough. Information presented is from scholarly though dated sources.

3. Satisfactory

4.4 points

Discussion of specific details of the clinical issue involving the selected medication is present but rendered at a perfunctory level.

2. Less Than Satisfactory

4 points

Discussion of specific details of the clinical issue involving the selected medication is present but incomplete.

1. Unsatisfactory

0 points

Discussion of specific details of the clinical issue involving the selected medication is not present.

Discussion of the Rationale Behind the Design Development

5 points

Criteria Description

Discussion of the Rationale Behind the Design Development

5. Excellent

5 points

A discussion of the rationale behind the design development is convincing and defines specific elements. Discussion is insightful and forward-thinking. Information presented is from current scholarly sources.

4. Good

4.6 points

A discussion of the rationale behind the design development is convincing and defines specific elements. Information presented is from scholarly though dated sources.

3. Satisfactory

4.4 points

A discussion of the rationale behind the design development is present but rendered at a perfunctory level.

2. Less Than Satisfactory

4 points

A discussion of the rationale behind the design development is present but incomplete.

1. Unsatisfactory

0 points

A discussion of the rationale behind the design development is not present.

Description of How Proposed CDSS Will Be Implemented and Adopted by Fellow Clinicians

10 points

Criteria Description

Description of How Proposed CDSS Will Be Implemented and Adopted by Fellow Clinicians

5. Excellent

10 points

A description of how the proposed CDSS will be implemented and adopted by fellow clinicians is present in full. Discussion is convincing and defines specific elements. Discussion is insightful and forward-thinking. Information presented is from current scholarly sources.

4. Good

9.2 points

A description of how the proposed CDSS will be implemented and adopted by fellow clinicians is present in full. Discussion is convincing and defines specific elements. Information presented is from scholarly though dated sources.

3. Satisfactory

8.8 points

A description of how the proposed CDSS will be implemented and adopted by fellow clinicians is present but rendered at a perfunctory level.

2. Less Than Satisfactory

8 points

A description of how the proposed CDSS will be implemented and adopted by fellow clinicians is present but incomplete.

1. Unsatisfactory

0 points

A description of how the proposed CDSS will be implemented and adopted by fellow clinicians is not provided.

Explanation of How Patient Outcomes Will Be Measured

5 points

Criteria Description

Explanation of How Patient Outcomes Will Be Measured

5. Excellent

5 points

An explanation of how patient outcomes will be measured is provided in full. Discussion is convincing and defines specific elements. Discussion is insightful and forward-thinking. Information presented is from current scholarly sources.

4. Good

4.6 points

An explanation of how patient outcomes will be measured is provided in full. Discussion is convincing and defines specific elements. Information presented is from scholarly though dated sources.

3. Satisfactory

4.4 points

An explanation of how patient outcomes will be measured is provided at a perfunctory level.

2. Less Than Satisfactory

4 points

An explanation of how patient outcomes will be measured is provided but explanation is incomplete.

1. Unsatisfactory

0 points

An explanation of how patient outcomes will be measured is not provided.

Assessment of Challenges and Proposed Solutions Which Might Apply to Scenario

10 points

Criteria Description

Assessment of Challenges and Proposed Solutions Which Might Apply to Scenario

5. Excellent

10 points

An assessment of challenges and proposed solutions which might apply to this scenario is clearly presented and thorough. Discussion is insightful, forward-thinking, and detailed. Information presented is from current scholarly sources.

4. Good

9.2 points

An assessment of challenges and proposed solutions which might apply to this scenario is clearly presented and thorough. Discussion is convincing and defines specific elements. Information presented is from scholarly though dated sources.

3. Satisfactory

8.8 points

An assessment of challenges and proposed solutions which might apply to this scenario is provided, but the assessment is rendered at a perfunctory level.

2. Less Than Satisfactory

8 points

An assessment of challenges and proposed solutions which might apply to this scenario is provided, but elements are missing or incomplete.

1. Unsatisfactory

0 points

An assessment of challenges and proposed solutions which might apply to this scenario is not provided.

Thesis Development and Purpose

7 points

Criteria Description

Thesis Development and Purpose

5. Excellent

7 points

Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.

4. Good

6.44 points

Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.

3. Satisfactory

6.16 points

Thesis is apparent and appropriate to purpose.

2. Less Than Satisfactory

5.6 points

Thesis is insufficiently developed or vague. Purpose is not clear.

1. Unsatisfactory

0 points

Paper lacks any discernible overall purpose or organizing claim.

Argument Logic and Construction

8 points

Criteria Description

Argument Logic and Construction

5. Excellent

8 points

Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.

4. Good

7.36 points

Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.

3. Satisfactory

7.04 points

Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis.

2. Less Than Satisfactory

6.4 points

Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.

1. Unsatisfactory

0 points

Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.

Mechanics of Writing (includes spelling, punctuation, grammar, language use)

5 points

Criteria Description

Mechanics of Writing (includes spelling, punctuation, grammar, language use)

5. Excellent

5 points

Writer is clearly in command of standard, written, academic English.

4. Good

4.6 points

Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech.

3. Satisfactory

4.4 points

Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed.

2. Less Than Satisfactory

4 points

Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied.

1. Unsatisfactory

0 points

Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.

Paper Format (Use of appropriate style for the major and assignment)

5 points

Criteria Description

Paper Format (Use of appropriate style for the major and assignment)

5. Excellent

5 points

All format elements are correct.

4. Good

4.6 points

Template is fully used; There are virtually no errors in formatting style.

3. Satisfactory

4.4 points

Template is used, and formatting is correct, although some minor errors may be present.

2. Less Than Satisfactory

4 points

Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent.

1. Unsatisfactory

0 points

Template is not used appropriately or documentation format is rarely followed correctly.

Documentation of Sources

5 points

Criteria Description

Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)

5. Excellent

5 points

Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.

4. Good

4.6 points

Sources are documented, as appropriate to assignment and style, and format is mostly correct.

3. Satisfactory

4.4 points

Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.

2. Less Than Satisfactory

4 points

Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.

1. Unsatisfactory

0 points

Sources are not documented.

Total 100 points