TY - GEN
T1 - Designing a clinical decision support prototype for urinary tract infection treatment in nursing homes
T2 - experiences from a research partnership
AU - Raban, Magda
AU - Gyawali, Rajendra
AU - Nguyen, Amy
AU - Lim , Lyn-li
AU - Stewart, Kyle
AU - Westbrook, Johanna
N1 - Copyright the Author(s) 2025. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.
PY - 2025/5/15
Y1 - 2025/5/15
N2 - The inappropriate use of antibiotics is frequent in nursing homes (NHs) putting older adults at risk of adverse events and contributing to the rise of antimicrobial resistance. Urinary tract infections (UTIs) account for 30-50% of antibiotic prescribing in NHs, but have one of the highest rates of inappropriate antibiotic use. Clinical decision support (CDS) embedded in electronic prescribing can assist in ensuring antibiotic appropriateness. In this study, we aimed to develop a CDS prototype to improve prescribing for UTIs in NHs in collaboration with an IT system provider, BESTMED. We used electronic health record data to identify CDS goals, and held design workshops with IT developers and an infectious diseases physician. Antibiotic choice and duration of treatment were identified as key areas requiring improvement, and thus the CDS goals. The final CDS prototype featured alerts when duration and antibiotic choice were not guideline concordant. A key challenge was ensuring the CDS operated within existing prescribing workflows. Plans for user testing and piloting the CDS to measure usability, acceptability and effectiveness are described.
AB - The inappropriate use of antibiotics is frequent in nursing homes (NHs) putting older adults at risk of adverse events and contributing to the rise of antimicrobial resistance. Urinary tract infections (UTIs) account for 30-50% of antibiotic prescribing in NHs, but have one of the highest rates of inappropriate antibiotic use. Clinical decision support (CDS) embedded in electronic prescribing can assist in ensuring antibiotic appropriateness. In this study, we aimed to develop a CDS prototype to improve prescribing for UTIs in NHs in collaboration with an IT system provider, BESTMED. We used electronic health record data to identify CDS goals, and held design workshops with IT developers and an infectious diseases physician. Antibiotic choice and duration of treatment were identified as key areas requiring improvement, and thus the CDS goals. The final CDS prototype featured alerts when duration and antibiotic choice were not guideline concordant. A key challenge was ensuring the CDS operated within existing prescribing workflows. Plans for user testing and piloting the CDS to measure usability, acceptability and effectiveness are described.
KW - Antimicrobial stewardship
KW - clinical decision support
KW - nursing homes
UR - http://www.scopus.com/inward/record.url?scp=105005816781&partnerID=8YFLogxK
U2 - 10.3233/SHTI250293
DO - 10.3233/SHTI250293
M3 - Conference proceeding contribution
C2 - 40380405
T3 - Studies in Health Technology and Informatics
SP - 158
EP - 162
BT - Intelligent health systems
A2 - Andrikopoulou, Elisavet
A2 - Gallos, Parisis
A2 - Arvanitis, Theodoros
A2 - Austin, Rosalynn
A2 - Benis, Arriel
A2 - Cornet, Ronald
A2 - Chatzistergos, Panagiotis
A2 - Dejaco, Alexander
A2 - Dusseljee-Peute, Linda
A2 - Mohasseb, Alaa
A2 - Natsiavas, Pantelis
A2 - Nakkas, Haythem
A2 - Scott, Phillip
PB - IOS Press
CY - Amsterdam
ER -