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Clinical Decision Support Systems for Pressure Ulcer Management: Systematic Review

dc.contributor.authorSousa, P.
dc.contributor.authorAraújo, Sabrina Magalhães
dc.contributor.authorDutra, Inês
dc.date.accessioned2021-10-19T08:47:20Z
dc.date.available2021-10-19T08:47:20Z
dc.date.issued2020
dc.description.abstractBackground: The clinical decision-making process in pressure ulcer management is complex, and its quality depends on both the nurse's experience and the availability of scientific knowledge. This process should follow evidence-based practices incorporating health information technologies to assist health care professionals, such as the use of clinical decision support systems. These systems, in addition to increasing the quality of care provided, can reduce errors and costs in health care. However, the widespread use of clinical decision support systems still has limited evidence, indicating the need to identify and evaluate its effects on nursing clinical practice. Objective: The goal of the review was to identify the effects of nurses using clinical decision support systems on clinical decision making for pressure ulcer management. Methods: The systematic review was conducted in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) recommendations. The search was conducted in April 2019 on 5 electronic databases: MEDLINE, SCOPUS, Web of Science, Cochrane, and CINAHL, without publication date or study design restrictions. Articles that addressed the use of computerized clinical decision support systems in pressure ulcer care applied in clinical practice were included. The reference lists of eligible articles were searched manually. The Mixed Methods Appraisal Tool was used to assess the methodological quality of the studies. Results: The search strategy resulted in 998 articles, 16 of which were included. The year of publication ranged from 1995 to 2017, with 45% of studies conducted in the United States. Most addressed the use of clinical decision support systems by nurses in pressure ulcers prevention in inpatient units. All studies described knowledge-based systems that assessed the effects on clinical decision making, clinical effects secondary to clinical decision support system use, or factors that influenced the use or intention to use clinical decision support systems by health professionals and the success of their implementation in nursing practice. Conclusions: The evidence in the available literature about the effects of clinical decision support systems (used by nurses) on decision making for pressure ulcer prevention and treatment is still insufficient. No significant effects were found on nurses' knowledge following the integration of clinical decision support systems into the workflow, with assessments made for a brief period of up to 6 months. Clinical effects, such as outcomes in the incidence and prevalence of pressure ulcers, remain limited in the studies, and most found clinically but nonstatistically significant results in decreasing pressure ulcers. It is necessary to carry out studies that prioritize better adoption and interaction of nurses with clinical decision support systems, as well as studies with a representative sample of health care professionals, randomized study designs, and application of assessment instruments appropriate to the professional and institutional profile. In addition, long-term follow-up is necessary to assess the effects of clinical decision support systems that can demonstrate a more real, measurable, and significant effect on clinical decision making.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationJMIR Med Inform 2020 | vol. 8 | iss. 10 | e21621pt_PT
dc.identifier.doi10.2196/21621pt_PT
dc.identifier.issn2291-9694
dc.identifier.urihttp://hdl.handle.net/10400.26/37698
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherChristian Lovispt_PT
dc.relation.publisherversionhttps://medinform.jmir.org/2020/10/e21621/PDFpt_PT
dc.rights.urihttp://creativecommons.org/licenses/by-nc/4.0/pt_PT
dc.subjectPressure ulcerpt_PT
dc.subjectDecision support systemspt_PT
dc.titleClinical Decision Support Systems for Pressure Ulcer Management: Systematic Reviewpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.issue10pt_PT
oaire.citation.startPagee21621pt_PT
oaire.citation.titleJMIR Medical Informaticspt_PT
oaire.citation.volumevol. 8pt_PT
person.familyNameSousa
person.givenNamePaulino
person.identifier.ciencia-id171D-6504-C2F0
person.identifier.orcid0000-0002-5778-0111
person.identifier.ridK-5173-2013
person.identifier.scopus-author-id35766265400
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublicationdd84fffa-56b1-4c8b-8012-faa9cdedaea3
relation.isAuthorOfPublication.latestForDiscoverydd84fffa-56b1-4c8b-8012-faa9cdedaea3

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