Evaluating the use of clinical decision aids in an Australian emergency department: A cross-sectional survey
Michaleff, Zoe A., Hattingh, Laetitia, Greenwood, Hannah, Mickan, Sharon, Jones, Mark, van der Merwe, Madeleen, Thomas, Rae, Carlini, Joan, Henry, David, Stehlik, Paulina, Glasziou, Paul, and Keijzers, Gerben (2024) Evaluating the use of clinical decision aids in an Australian emergency department: A cross-sectional survey. Emergency Medicine Australasia. (In Press)
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Abstract
Objective: To identify healthcare professionals' knowledge, self-reported use, and documentation of clinical decision aids (CDAs) in a large ED in Australia, to identify behavioural determinants influencing the use of CDAs, and healthcare professionals preferences for integrating CDAs into the electronic medical record (EMR) system.
Methods: Healthcare professionals (doctors, nurses and physiotherapists) working in the ED at the Gold Coast Hospital, Queensland were invited to complete an online survey. Quantitative data were analysed using descriptive statistics, and where appropriate, mapped to the theoretical domains framework to identify potential barriers to the use of CDAs. Qualitative data were analysed using content analysis.
Results: Seventy-four healthcare professionals (34 medical officers, 31 nurses and nine physiotherapists) completed the survey. Healthcare professionals' knowledge and self-reported use of 21 validated CDAs was low but differed considerably across CDAs. Only 4 out of 21 CDAs were reported to be used ‘sometimes’ or ‘always’ by the majority of respondents (Ottawa Ankle Rule for ankle injury, Wells' criteria for pulmonary embolism, Wells' criteria for deep vein thrombosis and PERC rule for pulmonary embolism). Most respondents wanted to increase their use of valid and reliable CDAs and supported the integration of CDAs into the EMR to facilitate their use and support documentation. Potential barriers impacting the use of CDAs represented three theoretical domains of knowledge, social/professional role and identity, and social influences.
Conclusions: CDAs are used variably by healthcare professionals and are inconsistently applied in the clinical encounter. Preferences of healthcare professionals need to be considered to allow the successful integration of CDAs into the EMR.
| Item ID: | 82194 |
|---|---|
| Item Type: | Article (Research - C1) |
| ISSN: | 1742-6723 |
| Keywords: | clinical decision support, decision-making, evidence-based emergency medicine, hospital emergency service, patient and public involvement, survey |
| Copyright Information: | This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. |
| Date Deposited: | 13 Mar 2024 02:09 |
| FoR Codes: | 52 PSYCHOLOGY > 5204 Cognitive and computational psychology > 520402 Decision making @ 70% 32 BIOMEDICAL AND CLINICAL SCIENCES > 3202 Clinical sciences > 320207 Emergency medicine @ 30% |
| SEO Codes: | 20 HEALTH > 2099 Other health > 209999 Other health not elsewhere classified @ 30% 28 EXPANDING KNOWLEDGE > 2801 Expanding knowledge > 280121 Expanding knowledge in psychology @ 70% |
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