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Running head: TECHNOLOGY IN NURSING 1 Evidence-Based Proposal and Annotated Bibliography on Technology in Nursing Student’s Name Institutional Affiliation

TECHNOLOGY IN NURSING 2 Evidence-Based Proposal and Annotated Bibliography on Technology in Nursing Introduction The growing focus on patient safety and quality of care has expanded the scope of nursing practice. Contemporary nurses are expected to play a major role in ensuring the quality of patient outcomes and are held accountable for their actions during care delivery. One specific technology that has gained attention in recent years is using electronic clinical documentation systems (ECDS) with clinical decision support (CDS) to enhance quality and safety standards in nursing. ECDS is a computer-based system that enables healthcare providers to document patient information electronically. The technology is widely used in healthcare settings to enhance the efficiency and accuracy of patient care documentation. Using ECDS in nursing practice impacts quality and safety standards in nursing positively. Hence, this annotated bibliography explores the literature on using ECDS with clinical decision support (CDS) to enhance quality and safety standards in nursing. The review will explore the literature on the use of ECDS with clinical decision support (CDS) to enhance quality and safety standards in nursing. The articles aim to examine the impact of ECDS on nursing practice, patient outcomes, and healthcare organization. The research process applied in this annotated bibliography entailed conducting an electronic search available through the Capella University Library database using key terms such as clinical decision support, clinical documentation, patient safety, EMR, EHR, and patient quality. Only studies published between 2017 and 2020 were included in the search. The abstracts of the selected studies were then reviewed to ensure that the methodology, sampling, study design, research question, findings, and conclusions were relevant to the topic. The articles were further assessed based on the titles and findings closely related to the keywords. Markedly,

TECHNOLOGY IN NURSING 3 this annotated bibliography summarizes the key literature on electronic clinical documentation with clinical decision support to enhance quality and safety standards in nursing. 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://www.nature.com/articles/s41746-020-0221-y The article provides an overview of the current state of clinical decision support systems (CDSS) and their likely benefits, risks, and strategies for success. The emphasis of the research is to review the literature on the use of CDSS and its potential impact on patient care and outcomes (Sutton et al., 2020). The authors conducted a literature review of studies published between 2010-2019 and determined that CDSS can help healthcare providers make more informed and accurate decisions about patient care, leading to enhanced patient outcomes, such as decreasing medication errors, improving diagnostic accuracy, and decreasing unnecessary tests (Sutton et al., 2020). However, the researchers also identified several risks associated with using CDSS, such as the likely over-reliance on the system and the need for constant maintenance and updates (Sutton et al., 2020). According to the authors, CDSS can improve healthcare practice quality and safety standards (Sutton et al., 2020). Still, more research is required to understand its impact and develop effective implementation strategies fully. The relevance of this technology to healthcare practice and the work of the interdisciplinary health care team is that it can enhance the decision-making process, as well as coordination among the team, leading to better patient outcomes. I selected this publication since it provides a comprehensive overview of the current state of CDSS in healthcare practice and underscores the

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TECHNOLOGY IN NURSING 4 potential benefits and risks associated with CDSS. The article also addresses the strategies for implementing and using CDSS. Park, Y. T., Kim, Y. S., Yi, B. K., & Kim, S. M. (2019). Clinical decision support functions and digitalization of clinical documents of electronic medical record systems. Healthcare Informatics Research , 25 (2), 115-123. https://doi.org/10.4258%2Fhir.2019.25.2.115 The article focuses on electronic medical record systems (EMR) and the potential benefits of incorporating clinical decision support functions (CDSF) into these systems. The researchers conducted a literature review of studies published between 2010 and 2018; they determined that incorporating CDSF into EMRs can lead to improved patient outcomes (Park et al., 2019). Park et al.’s (2019) article also determined that digitalizing clinical documents within EMRs can lead to improved accessibility and sharing of patient information among healthcare providers. According to Park et al. (2019), incorporating CDSF into EMRs can improve healthcare delivery quality and safety by helping providers make more informed decisions about patient care. Furthermore, the digitalization of clinical documents within EMRs can enhance the accessibility and sharing of patient information among healthcare providers, leading to improved coordination and continuity of care (Park et al., 2019). The authors underscore the potential of CDSF to improve patient outcomes and the significance of digitalizing clinical documents within EMRs for improved information sharing and care coordination (Park et al., 2019). The article is important in the current study as it focuses on the specific use of EMRs and the potential benefits of incorporating CDSF into these systems.

TECHNOLOGY IN NURSING 5 Gill, J., Kucharski, K., Turk, B., Pan, C., & Wei, W. (2019). Using electronic clinical decision support in patient-centered medical homes to improve management of diabetes in primary care: the DECIDE study. The Journal of Ambulatory Care Management , 42 (2), 105-115. The article focuses on the use of electronic clinical decision support (CDS) in patient- centered medical homes (PCMHs) to enhance the management of diabetes in primary care. The authors conducted research to evaluate the impact of CDS on diabetes management in a PCMH setting (Gill et al., 2019). The study determined that the use of CDS led to improved diabetes management, including better glycemic control and medication management (Gill et al., 2019). The research findings also determined that using CDS was associated with improved patient satisfaction (Gill et al., 2019). According to Gill et al. (2019), the use of CDS in PCMHs has the potential to enhance diabetes management in primary care and can lead to improved patient outcomes, such as better glycemic control and improved medication management, as well as patient satisfaction. The article also underscores the significance of CDS in providing evidence- based care, facilitating patient-centered care, and improving patient satisfaction (Gill et al., 2019). The article is important for the current topic since it focuses on the specific use of CDS in PCMHs and its potential to improve diabetes management in primary care. Dunn Lopez, K., Gephart, S. M., Raszewski, R., Sousa, V., Shehorn, L. E., & Abraham, J. (2017). Integrative review of clinical decision support for registered nurses in acute care settings. Journal of the American Medical Informatics Association , 24 (2), 441- 450. https://doi.org/10.1093/jamia/ocw084

TECHNOLOGY IN NURSING 6 The article examines the impact of clinical decision support (CDS) systems on patient safety and quality of care in acute care settings. The research focuses on reviewing the literature on the use of CDS for registered nurses in acute care settings (Dunn Lopez et al., 2017). The article provides an overview of the current state of CDS in nursing practice, and the authors conducted a literature review of studies published between 2004 and 2014 (Dunn Lopez et al., 2017). The authors found that CDS systems can help nurses make more informed and accurate decisions about patient care, leading to improved patient outcomes (Dunn Lopez et al., 2017). The authors also identified several barriers to implementing CDS in nursing practice, including a need for more computer literacy among nurses and resistance to change among healthcare providers (Dunn Lopez et al., 2017). According to Dunn Lopez et al. (2017), CDS can enhance quality and safety standards in nursing practice. However, more research is needed to understand its impact and develop effective implementation strategies fully. The relevance of this technology to nursing practice and the work of the interdisciplinary healthcare team is that it can enhance the decision-making process and coordination among the team, leading to better patient outcomes. Overall, the article provides a comprehensive overview of the current state of CDS in nursing practice and underscores the potential benefits of CDS for registered nurses in acute care settings, including improved patient outcomes. The authors also address the barriers to implementation and the need for further research (Dunn Lopez et al., 2017). The article also addresses the barriers to implementation, including nurses' need for more computer literacy and resistance to change among healthcare providers (Dunn Lopez et al., 2017). The article is significant in learning since all the

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TECHNOLOGY IN NURSING 7 publications studied highlight the potential benefits of CDS systems in nursing practice, including improved patient outcomes and decision-making processes. Conclusion Electronic clinical documentation systems (ECDS) with clinical decision support (CDS) can significantly enhance quality and safety standards in nursing practice. The literature reviewed in this annotated bibliography emphasizes the potential benefits of CDS, such as improved patient outcomes, better decision-making processes, and improved coordination among the interdisciplinary team. Furthermore, ECDS can improve the accessibility and sharing of patient information among healthcare providers, leading to better coordination and continuity of care. All the articles in the annotated bibliography provide evidence-based resources that prove the effectiveness of ECDS and CDS in enhancing patient outcomes and care delivery. Furthermore, the organizational factors that should be considered when implementing ECDS and CDS, such as organizational policies, resources, culture or social norms, commitment, training programs, and employee empowerment, have also been discussed. Markedly, healthcare organizations must consider the implementation and use of ECDS and CDS to enhance quality and safety standards in nursing practice.

TECHNOLOGY IN NURSING 8 References Dunn Lopez, K., Gephart, S. M., Raszewski, R., Sousa, V., Shehorn, L. E., & Abraham, J. (2017). Integrative review of clinical decision support for registered nurses in acute care settings. Journal of the American Medical Informatics Association , 24 (2), 441-450. https://doi.org/10.1093/jamia/ocw084 Gill, J., Kucharski, K., Turk, B., Pan, C., & Wei, W. (2019). Using electronic clinical decision support in patient-centered medical homes to improve management of diabetes in primary care: the DECIDE study. The Journal of Ambulatory Care Management , 42 (2), 105-115. Park, Y. T., Kim, Y. S., Yi, B. K., & Kim, S. M. (2019). Clinical decision support functions and digitalization of clinical documents of electronic medical record systems. Healthcare Informatics Research , 25 (2), 115-123. https://doi.org/10.4258%2Fhir.2019.25.2.115 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://www.nature.com/articles/s41746- 020-0221-y

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