DNP 805 Using CPOE and CDSS
Grand Canyon University DNP 805 Using CPOE and CDSS-Step-By-Step Guide
This guide will demonstrate how to complete the DNP 805 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 Using CPOE and CDSS
Whether one passes or fails an academic assignment such as the Grand Canyon University DNP 805 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 Using CPOE and CDSS
The introduction for the Grand Canyon University DNP 805 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 Using CPOE and CDSS
After the introduction, move into the main part of the DNP 805 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 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 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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Sample Answer for DNP 805 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, phar
macists, 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.
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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.
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
Sample Answer 2 for DNP 805 Using CPOE and CDSS
Over the years, healthcare professionals have dealt with various conditions and illnesses that trouble individuals and populations. While some of these illnesses onset away from the hospital and thus require hospital admissions, some are developed while individuals have been admitted into the hospitals. One such condition is pressure ulcers. Even though various strategies have been applied to prevent and manage pressure ulcers, the condition is still prevalent and impacts patients negatively (BoykoTatiana et al., 2018). In particular, the pain resulting from the wounds usually causes patients suffering, calling for better prevention and management of the same. In attempts to find better remedies, various stakeholders have turned to technological solutions. For example, the use of Clinical Decision Support System (CDSS) and the Computer Provider Order Entry (CPOE) have particularly been used in supporting the medication administration for better pharmacological outcomes (Shahmoradi et al., 2021). Therefore, the purpose of this assignment is to formulate a CDSS using a CPOE to be integrated into the Electronic Health Records to support the management of pain among patients experiencing pressure ulcer
The CDSS Design and the Rationale Behind the Design
The Computer Provider Order Entry entails using a computer for medication order entries as well as storage of the orders digitally. The CPOE also enables the entry of other data such as a patient’s imaging data, diagnostic test results, laboratory test results, and discussions held between the professionals. Traditionally, CDSS was majorly characterized by helping professionals make appropriate care and patient decisions. However, the current systems even allow for a display of an individual’s past status while supporting other evaluations and recommendations (Shahmoradi et al., 2021). As such, the advantages of using CDSS can be tapped and fine-tuned to ensure that patients with pressure ulcers get better pain management hence improved outcomes.
The designed CDSS is to be composed of a computer algorithm created to gather the patient’s important information such as the existing medication, comorbidities, the patient’s skin condition, the degree of pain, age, and gender. As part of the system, the system will be key in offering the clinicians the necessary support when deciding on the best medication to be given to the patient depending on the collected data. The core design of the system will also have definitions, queries, and access tables which help in matching an individual’s current health condition with what is in the electronic health record. This system has been proposed to help eliminate possible medication errors and prevent possible adverse drug interactions when offering care to patients with pressure ulcers (Shahmoradi et al., 2021). The elimination of medication errors and avoidance of drug interactions is obtained by giving the information in a simple and easily understood form and format. The proposed system will also be formulated so that it can easily be integrated into the facility’s electronic health record system.
The Implementation of the System and its Adoption by Fellow Clinicians.
A good plan should be in place to enable a successful implementation of the designed system. As part of the plan, the staff will have to undergo a comprehensive education and training session. The content of the training will be tips on using the new system, the reasons why the facility needs the new system, the main features and the advantages of using it. As such, a total period of two weeks will be set aside for training and testing the new system. The staff workflows and responsibilities are to be modified to ensure that every staff engaged in the management and care of the patients with pressure ulcers can easily log in to the system and check the status of any patient of concern. Security is important when using such systems; therefore, anyone logging into the system will be required to undergo a one-step password authentication to only allow the right users.
After logging in, the clinician then in feeds the current information, such as the pressure ulcer indicators, into the EHR, opens the CDSS, and reviews the treatment options available for the patient as information to the individual’s health information. The clinician then makes an assisted decision on the best medication that can be administered to the patient. Such a decision is then followed by the use of a CPOE to make medication order. The clinician then reviews the medication information that appears on the resolution table to ensure that everything is aligned. If there are any adjustments to be carried out, the professional states such a reason through a drop-down selection.
Potential Challenges and Possible Solutions.
The use of the created CPOE-assisted CDSS system in the facility implies that the organization’s operations will have to undergo some changes and adjustments. Evidence has it that introducing a change process in any organization can come with various challenges. One of the prime challenges is staff resistance to the change being introduced. Such resistance may stem from various reasons, including viewing the proposed change as bothersome, existing misconceptions regarding CPOE and CDSS, and possible fear of the unknown (Westerbeek et al., 2021). Solving such a resistance to the proposed change is key as resistance is known to negatively impact the implementation process, which can also extend to the use of the implemented system.
Offering a comprehensive education and training on the new system to the staff is one key strategy that can be used in solving resistance. In such a training, the staff is given valid reasons why the facility needs the new CDSS system and what expected benefits would be experienced upon its implementation. The new system will be integrated into the electronic health system, which has been key in simplifying the work to help in enhancing patient care and outcomes too. The problem of medication errors is not a secret in any patient care setting, and therefore, such incidences can be used to ensure that the staff buys into the idea of using the CDSS system to lower the incidence of medication errors. When the new system is used, there are high chances that the medication error incidences will greatly be reduced (Westerbeek et al., 2021). The staff can also be trained on how to operate the new system to help do away with resistance caused by insufficient knowledge of how to operate the new system. Again, the staff also needs to be trained and informed on the integration of the new system into the already existing EHR system.
The other barrier is the fear of potential loss of autonomy (Westerbeek et al., 2021). The staff may resist the use of the new system due to the fear that the new system would snatch away their autonomy as the system does the work more accurately and promptly. The implication is that with the new system in place, the best treatment regimen for the patients can be offered even without the clinician’s input. This barrier can be overcome by assuring the staff that the new CDSS system will only assist in reducing their workload. Hence they can put more energy into special areas of patient care to improve care outcomes.
Conclusion
The demand for better and more efficient patient care and services in the care setting has led to various inventions and innovations. CDSS and CPOE have been used for years to improve patient outcomes. However, a combination of these two technologies still presents genuine opportunities to exploit and ensure that patient outcome are better. Therefore, a CPOE-assisted CDSS system has been proposed to improve the use of pain medications to enhance the management of pain among patients with pressure ulcers. This system can be embedded into the electronic health record system to improve care outcomes.
References
BoykoTatiana, V., LongakerMichael, T., & YangGeorge, P. (2018). Review of the current management of pressure ulcers. Advances in Wound Care. https://doi.org/10.1089/wound.2016.0697
Shahmoradi, L., Safdari, R., Ahmadi, H., & Zahmatkeshan, M. (2021). Clinical decision support systems-based interventions to improve medication outcomes: A systematic literature review on features and effects. Medical Journal of the Islamic Republic of Iran, 35, 27. https://dx.doi.org/10.47176%2Fmjiri.35.27.
Westerbeek, L., Ploegmakers, K. J., de Bruijn, G. J., Linn, A. J., van Weert, J. C., Daams, J. G., … & Medlock, S. (2021). Barriers and Facilitators Influencing Medication-Related CDSS Acceptance According to Clinicians: A Systematic Review. International Journal of Medical Informatics, 104506. https://doi.org/10.1016/j.ijmedinf.2021.104506