Effect of a computerized decision support system on the treatment approach of stage III or IV pressure injury in patients with spinal cord injury: a feasibility study

BMC Health Services Research, 2023 · DOI: 10.1186/s12913-023-09045-y · Published: January 19, 2023

Simple Explanation

The study investigates the use of a computerized decision support system (CDSS) to aid in the complex treatment of stage III and IV pressure injuries (PIs) in patients with spinal cord injury (SCI). These injuries require coordinated care, and the CDSS was designed to improve treatment adherence and collaboration among healthcare professionals. The CDSS followed the Basel Decubitus Approach and aimed to guide healthcare professionals through the treatment process, ensuring relevant steps were followed. The system provided reminders and managed tasks to optimize adherence to treatment processes. The feasibility study explored the perspectives of healthcare professionals on using the CDSS. Focus groups were conducted to identify potential barriers and facilitators to the system's effective implementation in clinical settings.

Study Duration

July 2016 and May 2017

Participants

Thirty patients with SCI admitted for stage III/IV PI

Evidence Level

Not specified

Key Findings

1
No statistically significant differences were observed in treatment adherence, frequency of major and minor complications, and length of stay between the CDSS and control groups.
2
Healthcare professionals found the CDSS to be helpful for visualizing the treatment process.
3
High workload and difficulties in information technology processes, such as missing reminders, slow computer performance and data processing, and poor accessibility, hindered the effective implementation of the CDSS.

Research Summary

This feasibility study examined the effect of a CDSS on adherence to the Basel Decubitus Approach for treating stage III/IV pressure injuries in SCI patients, comparing complication rates, length of stay, and costs between standard and CDSS-supported care. It also explored healthcare professionals’ perspectives on using the CDSS. The implementation of the CDSS was feasible and included definitions of milestones, interventions, and outcomes. However, no significant improvements in clinical or economic outcomes were observed during the study period. Healthcare professionals acknowledged the CDSS's potential to improve quality of care by integrating guideline recommendations and supporting interdisciplinary treatment, but technical difficulties and time-consuming tasks hindered its use.

Practical Implications

Technical Improvements

Address technical difficulties such as slow performance and missing reminders to enhance CDSS usability.

Integration

Solid integration of the CDSS into the clinical information system is necessary for seamless workflow.

Longer Observation

A longer observation period is required to fully assess the impact of the CDSS on clinical outcomes.

Study Limitations

1
The study had a small sample size.
2
The CDSS was used in an extra IT system, hindering implementation due to infrequent use.
3
The study was influenced by the disappointing perception of spending money on an IT system that was subsequently abandoned.

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