Study Set Content:
Ranges from a simple reminder to complex algorithms to recommend or change therapy. ➢ Functions include checking allergies, duplicatetherapies, drug interactions and abnormal dosage ranges.
CLINICAL DECISION SUPPORT SYSTEM (CDSS)
Pharmacists, however, would admit that CDSS tools are not always effectively utilized in CPOE systems because many alerts are clinically () while important alerts are often ().
insignificant, inadequately addressed
In addition, many systems have not allowed pharmacists to
access patient information
Over the years, CDSS assists clinicians in selecting and delivering the safest and most effective
therapies
The first CDSS became available in the early
1970’s
The clinician inputs the patient parameters, and the system would compare the data or use it in a set of algorithms to provide an evidence-based diagnosis or list of treatment options.
stand-alone diagnostic aids
Today, prescribers can benefit from CDSS which provide information to guide diagnosis and recommend () options, including appropriate medication dosing and information on cost of therapy and institutional formularies.
evidence-based treatment
However, these systems are only useful if their reference knowledge base is
current and complete.
are examples of vendors that are used as information source by CDSS.
Multum and First Databank
Today, stand-alone CDSS can still be found in other systems such as
POISINDEX, QMR, and DxPlain.
Some CDSS is integrated in () which is used as a tool to track inventory and retail sales patterns.
bar code technology
Also, it can confirm and document that a patient is being given the () of medication at the correct time and even prompt the administering care provider if lab results or new medications may need to be considered before administering an ordered medication.
correct dose
CDSS in conjunction with () has been shown to reduce medication errors, improve compliance with recommended monitoring or adjunctive therapies, and improve efficiency by reducing time spent clarifying incomplete orders.
CPOE
Essentially, all CPOE systems incorporate some degree of
CDSS
have the ability to screen for a variety of potential risks at the time of order entry, including duplicate therapy, drug-drug, drugdisease, drug-lab value interactions, allergic crosssensitivities, and appropriate dosing.
CPOE-based CDSS
CDSS may be incorporated into the() to screen for recent changes in lab parameters, vital signs, or allergy status, which may interact with a scheduled medication and alert the nurse prior to administration
eMAR (electronic medication administration record)
can only be effective when associated with an up-to-date and comprehensive knowledge base to serve as a source of potential drug-lab value and allergen interactions.
eMAR-based CDSS
can provide realtime confirmation of the “five rights” of medication administration
An eMAR-based CDSS coupled with bar code labels or radio frequency identification (RFID) technology and bedside scanning
“five rights” of medication administration
Right medication
• Right dose
• Right route
• Right patient,
• Right time
CDSS technology has been integrated into pumps used for administration for parenteral medication known as
smart pumps
