Clinical decision support in promoting evidence-based nursing in primary healthcare: a cross-sectional study in Finland.

IF 2.7 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Jbi Evidence Implementation Pub Date : 2023-09-01 DOI:10.1097/XEB.0000000000000375
Lotta Hamari, Heidi Parisod, Hannele Siltanen, Kristiina Heikkilä, Tiina Kortteisto, Ilkka Kunnamo, Heidi Pukkila, Arja Holopainen
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Abstract

Introduction and aims: The aim was to explore clinical decision support (CDS) use in the practice of primary healthcare nurses. The objectives were to recognize to what extent nurses (registered nurses, public health nurses, and practical nurses) use CDS, what factors were associated with the CDS used, what kind of organizational support nurses need, and what were nurses' views about CDS development needs.

Methods: The study was conducted with a cross-sectional study design, using an electronic questionnaire developed for this purpose. The questionnaire contained 14 structured questions and nine open-ended questions. The sample consisted of randomly selected primary healthcare organizations ( N  = 19) in Finland. Quantitative data were analyzed using cross-tabulation and Pearson's chi-squared test, and qualitative data with quantification.

Results: A total of 267 healthcare professionals (age range 22-63 years) volunteered to participate. Participants were mainly registered nurses, public health nurses, and practical nurses (46.8, 24, and 22.9%, respectively). Overall, 59% of the participants had never used CDS. The majority (92%) found it necessary to develop nursing-specific content for CDS. The most commonly used features were medication recommendations and warnings (74%), reminders (56%), and calculators (42%). Half of the participants (51%) had not received training on the use of CDS. The older age of participants was associated with the feeling of not having enough training to use CDS ( P  = 0.039104). Nurses felt that CDS was helpful in their clinical work and decision-making, promoting evidence-based practice, and narrowing the research-into-practice gap, improving patient safety and the quality of care, and helping those who are new in their work.

Conclusion: CDS and its support structures should be developed from a nursing perspective to achieve the full potential of CDS in nursing practice.

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临床决策支持在促进循证护理初级保健:芬兰的横断面研究。
简介和目的:目的是探讨临床决策支持(CDS)在初级保健护士的实践中使用。目的是了解护士(注册护士、公共卫生护士和实习护士)使用CDS的程度,与CDS使用相关的因素,护士需要什么样的组织支持,以及护士对CDS发展需求的看法。方法:本研究采用横断面研究设计,使用为此目的开发的电子问卷。调查问卷包含14个结构化问题和9个开放式问题。样本包括芬兰随机选择的初级卫生保健组织(N = 19)。定量资料采用交叉表法和Pearson卡方检验,定性资料采用定量分析。结果:共有267名医疗保健专业人员(年龄22-63岁)自愿参加。参与者主要为注册护士、公共卫生护士和执业护士(分别为46.8%、24%和22.9%)。总体而言,59%的参与者从未使用过CDS。大多数人(92%)认为有必要为CDS制定护理特定内容。最常用的功能是药物建议和警告(74%),提醒(56%)和计算器(42%)。一半的参与者(51%)没有接受过使用CDS的培训。年龄较大的参与者感觉没有足够的训练来使用CDS (P = 0.039104)。护士认为,CDS有助于他们的临床工作和决策,促进循证实践,缩小研究与实践之间的差距,提高患者安全和护理质量,并帮助那些新来的人。结论:应从护理的角度发展CDS及其支持结构,以充分发挥CDS在护理实践中的潜力。
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来源期刊
CiteScore
3.20
自引率
13.00%
发文量
23
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