Resolving a Clinical Issue Using CPOE and CDSS Term Paper

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Computerized Provider Order Entry (CPOE) integrated with Clinical Decision Support System (CDSS) is regarded as a crucial system for enhancing the quality, safety, and efficiency of care (Simon et al., 2013). This system helps in enhancing care through preventing and/or lessening medication errors and promoting the use of evidence-based treatments. CPOE is basically defined as any system through which clinicians directly enter medications, tests, or procedure orders. Once these orders are entered, they are transmitted to the responsible clinician for executing it such as laboratory and pharmacy department. This paper will discuss the use of CPOE system integrated in a CDSS to address electrolyte replacements in patients who have undergone cardiac surgeries, which is a clinical issue involving medication.

Clinical Issue Involving Medication

The selected clinical issue involving medication for this assignment is electrolyte replacements in patients who have undergone cardiac surgeries given that electrolyte disorders are common after cardiac surgery (Couture, Létourneau, Dubuc, & Williamson, 2013). For instance, it is reported that electrolyte disorders like hypokalemia, hypomagnesemia, hypophosphatemia, and hypocacelmia occur in 34%, 46%, 83%, and 7.8% of these patients respectively (Couture, Létourneau, Dubuc, & Williamson, 2013). Electrolyte disorders in the aftermath of a cardiac surgery has become a major clinical issue because it’s associated with complications like seizure and tetany, hemodynamic instability, impaired diaphragmatic contractility and cardiac arrhythmias.

Existing studies have shown that the complications emerging from electrolyte disorders can be reduced to help enhance clinical outcomes among these critically-ill patients. Based on the findings of recent studies on this clinical issue, the use of repletion protocols is more effective as compared to standard methods of conducting electrolyte repletion.

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For this project, the researcher will focus on potassium chloride as a medication whereas potassium is the electrolyte contributing to the electrolyte disorder.

Rationale behind the Design Development

The rationale behind development of this CPOE system to be integrated clinical decision support system is that potassium is a major intracellular cation whose imbalance can have severe impacts on tissues. Since potassium is an electrolyte, potassium imbalance contributes to some of the most common electrolyte disorders such as hypokalemia. While there are regulations for repletion of this electrolyte using potassium chloride as the medication, clinicians tend to forget using these guidelines. Actually, clinicians tend to forget checking the laboratories to replace potassium, which in turn contributes to electrolyte disorders. Therefore, this system is developed to help provide reminders to clinicians to carryout suitable laboratory monitoring with regards to this electrolyte (Ranji, Rennke & Wachter, 2013).

The Computerized Provider Order Entry (CPOE) system for this project will provide alerts to help remind nurses to check the laboratory for repletion of this electrolyte to improve patient outcomes. The system will provide alerts on the premise that normal serum potassium is between 3.6mEq/L and 5.0mEq/L, but 4.0mEq/L is the optimal level for most patients (Gwinnett Hospital System, 2017). The alerts in the CPOE system, which will be administered during the duration of care, are as follows:….....

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