Clinical Decision Support System
1. Right medication 2. Right dose 3. Right route 4. Right patient 5. Right time
5 rights of medication administration
CDS Governance Committee
A committee that should be established after the implementation of CDSS inside the hospital.
Arden syntax standard
A programming language designed for clinicians to build clinical rules.
Health Level Seven
A standards development organization for health information technology (HIT)
Alert fatigue
A state of irritability, exhaustion, or bewilderment triggered in clinicians who have been exposed to too many alerts which cause the user to ignore some or all the alerts.
Clinical Decision Support System
A system intended to provide CDS to clinicians, caregivers and health care consumers.
1. A Knowledge base 2. An Event monitor 3. A Communication system
Automated CDSS includes
Bar code scanning technology and e-Prescribing
CDSS may be integrated into other technology solutions
Data mining
Encompasses numerous methods used to identify patterns and relationships in data
Look-Alike, Sound-Alike
Drugs with similar spelling or pronunciation
1. Data mining 2. Informational notice 3. Order sets 4. Knowledge retrieval systems
Non-patient specific CDSS
a. Error of commission b. Error of omission
Prevent errant action at the point of care
Google and Pub Med
Primary KRS
Bar Code Medication Administration
Provides warnings if any of the five rights are violated.
Harrison's online
Secondary KRS
ASHP, Thomson Health care and lexicomp
Tertiary KRS
Delay in care
The risk that interruptions in the workflow caused by clinical decision support alerts or system limitations may lead to a delay in delivery of patient care.
A. Patient-specific CDSS B. Non-patient specific CDSS
Types of Clinical Decision Support System
1. Alert fatigue 2. Delay in care 3.System performance
Unintended consequences in CDS
Medical Logical Modules
a clinical decision or action, or an informational notice to report a change in a patient's clinical status.
Smart pump
a computerized infusion device that can be programmed to include a specific set of data.
Alert fatigue
users to become overwhelmed and begin to ignore CDS messages due to a high quantity of alerts or a perception that the alerts have little perceived value.
Automated Dispensing Cabinets
acronym ADC
Electronic Medication Administration
acronym EMAR
Medical Logical Modules
acronym MLMs
American National Standards Institute
acronym of ANSI
Bar Code Medication Administration
acronym of ANSI
Health Level Seven
acronym of HL7
Look-Alike, Sound-Alike
acronym of LASA
American National Standards Institute
coordinates for the development of Health Level Seven's Arden Syntax Standard
Columbia University's Arden Homestead in 1989
develop the Arden syntax standard
Clinical Decision Support
providing clinicians or patients with clinical knowledge and patient-related information, intelligently filtered or presented to appropriate times, to enhance patient care.
ADC
secure storage cabinets typically located decentrally on patient care units capable of handling most unit-dose and multiple dose medications.
System Performance
used by the CDSS will cause the hospital information system software to perform slowly.