Thematic analysis of nurse practitioners use of clinical decision support tools and clinical mobile apps for prescriptive purposes
Thematic analysis of nurse practitioners use of clinical decision support tools and clinical mobile apps for prescriptive purposes
复制标题
DOI：
10.1097/jxx.0000000000000170
复制
发表时间：
2019-09-01
影响因子：
1.2
通讯作者：
Bost, Kirsten
中科院分区：
文献类型：
--
作者：
Dodson, Crystal Heath;Baker, Elizabeth;Bost, Kirsten
背景和目的：临床实施精准医学的一个障碍是缺乏容易获得的同行评议的、全面的临床实践指南。因此，需要一种易于访问的格式来推动医疗保健提供者采用这些指南。了解提供者开处方的过程将为临床决策支持工具的开发提供信息，特别是与精准医疗相关的工具。移动应用程序的成功使用将取决于医疗保健提供者的支持。本研究的目的是通过对执业护士的访谈来评估临床决策支持工具和移动应用程序的可信度。方法：采用描述性定性研究设计。研究中使用了10名积极开药的护士作为样本。结论：参与者对这些处方技术有消极和积极的态度。总的来说，从这个专题分析中出现了四个主题：使用药剂师来帮助当前的处方实践，依赖电子病历作为临床决策支持工具，在临床实践中缺乏移动应用程序的使用，但如果这些资源负担得起且可靠，则希望拥有这些资源。对实践的影响：参与者意识到使用移动应用程序进行临床决策支持，但由于缺乏可负担性和可靠性，这些工具的采用受到限制。因此，为了克服这些障碍，采用与精准医疗相关的移动应用程序，必须开发基于可靠来源的应用程序的可负担性和透明度。
Background and purpose: An obstacle to clinical implementation of precision medicine is the absence of easily accessible peer-reviewed, comprehensive clinical practice guidelines. Therefore, an easily accessible format is needed to propel the adoption of these guidelines by healthcare providers. An understanding of the process providers take to prescribe medications will inform development of clinical decision support tools, specifically related to precision medicine. Successful use of mobile applications will depend on the buy-in from healthcare providers. The purpose of this study was to assess perceptions of trustworthiness surrounding clinical decision support tools and mobile applications through interviews with nurse practitioners.Methods: A descriptive, qualitative research design was used. A sample of 10 nurse practitioners who actively prescribe medication was used within the study.Conclusions: The participants mentioned both negative and positive attitudes regarding these prescribing techniques. Overall four themes emerged from this thematic analysis: the use of pharmacists to help with current prescribing practices, reliance on the EMR as a clinical decision support tool, lack of mobile app use in clinical practice, but the desire to have these resources if they were affordable and reliable.Implications for practice: The participants were aware of the use of mobile apps for clinical decision support, but the adoption of these tools was limited due to the perceived lack of affordability and reliability. Therefore, to overcome these barriers to adoption of a mobile app related to precision medicine, affordability and transparent construction of an app grounded in credible sources must be developed.