Effects of a Computer-based Clinical Decision Support System for Preventing and Treating Pressure Ulcers and Undernutrition in Nursing Homes

The overall purpose is to gain a better understanding of health personnels use of computerized clinical decision support systems (CDSS) in clinical practice and the effects on clinical performance and patient care outcomes. CDSS used in this study is base d on two guidelines: Mini Nutritional Assessment (MNA) and the Risk Assessment Pressure Score (RAPS). These two text guidelines are made available within an existing information system. All health personnel in this group went through CDSS user training a nd education on how to prevent and treat pressure ulcers and undernutrition on patients in nursing homes through the intervention period. The aim is to investigate the effects of CDSS on patient care outcomes concerning pressure ulcers and undernutrition in nursing homes. The project will be accomplished by data collection with multiple methods and designs and has four separate studies. Methods are interviews with think- aloud (TA) technique, analyse of patient records pre- and post, measure pre- and post with; RAPS-scale and the MNA-scale, and focus-group interviews. The measurements are done in the study both pre and post intervention period, in inspections and the intervention group, from the patients on the variables; risk of development of pressure u lcers and undernutrition. The variables that are measured are; pressure ulcers; the RAPS-scale on all patients with 12 month intervals and undernutrition; the MNA-scale on all patients with 12 month intervals. The EHR that is applied by health personnel i n the study is implemented in the agency that the informants are recruited from. The study included 520 collected mappings of results/data on pressure ulcers and undernutrition from nursing homes with dissimilar sizes, according to power calculation 170 p atients are involved in each group (two control groups and an intervention group).