DNP 805 Topic 3 Using CPOE and CDSS GCU

dnp 805 topic 3 using cpoe and cdss gcu

DNP 805 Topic 3 Using CPOE and CDSS GCU

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.

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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.

Details:

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.
  • Doctoral learners are required to use APA style for their writing assignments. The APA Style Guide is located in the Student Success Center.
  • Use primary sources published within the last 5 years. Provide citations and references for all sources used.
  • You are required to submit this assignment to Turnitin. Refer to the directions in the Student Success Center.

Directions:

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

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

Portfolio Practice Hours:

It may be possible to earn portfolio practice hours for this case report. Enter the following after the references section of your paper:

Practice Hours Completion Statement DNP-805

I, (INSERT NAME), verify that I have completed (NUMBER OF) clock hours in association with the goals and objectives for this assignment. I have also tracked said practice hours in the Typhon Student Tracking System for verification purposes and will be sure that all approvals are in place from my faculty and practice mentor

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.

  1. 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.

  1. 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.

  1. 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

  1. 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.

  1. 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.

  1. Satisfactory

4.4 points

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

  1. 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

  1. 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.

  1. 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.

  1. 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.

  1. 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

  1. Excellent

7 points

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

  1. 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.

  1. Satisfactory

6.16 points

Thesis is apparent and appropriate to purpose.

  1. 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

  1. Excellent

8 points

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

  1. 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.

  1. 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.

  1. 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)

  1. Excellent

5 points

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

  1. 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.

  1. 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.

  1. 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)

  1. Excellent

5 points

All format elements are correct.

  1. Good

4.6 points

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

  1. Satisfactory

4.4 points

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

  1. 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)

  1. Excellent

5 points

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

  1. Good

4.6 points

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

  1. Satisfactory

4.4 points

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

  1. 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

ADDITIONAL INSTRUCTIONS FOR THE CLASS

Discussion Questions (DQ)

  • Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.
  • Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.
  • One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.
  • I encourage you to incorporate the readings from the week (as applicable) into your responses.

Weekly Participation

  • Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
  • In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
  • Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).
  • Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

APA Format and Writing Quality

  • Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
  • Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
  • I highly recommend using the APA Publication Manual, 6th edition.

Use of Direct Quotes

  • I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.
  • As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.
  • It is best to paraphrase content and cite your source.

 

LopesWrite Policy

  • For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.
  • Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.
  • Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
  • Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.

Late Policy

  • The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
  • Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.
  • If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.
  • I do not accept assignments that are two or more weeks late unless we have worked out an extension.
  • As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

Communication

  • Communication is so very important. There are multiple ways to communicate with me: 
    • Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
    • Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.
Grading Rubric

  Accomplished Emerging Unsatisfactory
Content Points Range:62.25 (41.50%) – 75 (50.00%)Responds clearly, thoroughly, and effectively to all aspects of the assignment. All content is accurate and/or supported. Points Range:57 (38.00%) – 61.5 (41.00%)Responds adequately to the assignment but may not be thorough. Points Range:0 (0.00%) – 56.25 (37.50%)Does not respond to the assignment.
Focus and Detail Points Range:31.125 (20.75%) – 37.5 (25.00%)There is a clear, well-focused topic. Main ideas are clear and are well supported by detailed and accurate information gathered from scholarly sources. Points Range:28.5 (19.00%) – 30.75 (20.50%)There is a clear, well-focused topic. Main ideas are clear but are not well supported by scholarly sources and detailed information. Points Range:0 (0.00%) – 28.125 (18.75%)The topic and main ideas are not clear.
Organization Points Range:18.675 (12.45%) – 22.5 (15.00%)The introduction is inviting, states the main topic, and provides an overview of the paper. Information is relevant and presented in a logical order. The conclusion is strong. Points Range:17.1 (11.40%) – 18.45 (12.30%)The introduction states the main topic and provides an overview of the paper. A conclusion is included. Points Range:0 (0.00%) – 16.875 (11.25%)There is no clear introduction, structure, or conclusion.
Mechanics and APA Points Range:12.45 (8.30%) – 15 (10.00%)The assignment consistently follows current APA format and is free of errors in formatting, citation, and references. There are no grammatical, spelling, or punctuation errors. All sources are correctly cited and referenced. Points Range:11.4 (7.60%) – 12.3 (8.20%)The assignment consistently follows current APA format with only isolated and inconsistent mistakes and/or has a few grammatical, spelling, or punctuation errors. Most sources are correctly cited and referenced. Points Range:0 (0.00%) – 11.25 (7.50%)The assignment does not follow current APA format and/or has many grammatical, spelling, or punctuation errors. Many sources are incorrectly cited and referenced or citations and references are missing.

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