Implementation of a Clinical Decision Support Tool to Aid Wound Infection Identification

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dc.contributor.advisorTse, Alice
dc.contributor.authorLerner, Jennifer
dc.contributor.departmentNursing
dc.date.accessioned2022-10-19T22:36:10Z
dc.date.available2022-10-19T22:36:10Z
dc.date.issued2022
dc.description.degreeD.N.P.
dc.identifier.urihttps://hdl.handle.net/10125/103908
dc.subjectNursing
dc.subjectChronic wound
dc.subjectClinical Decision Support Tool
dc.subjectHome Health
dc.subjectInfection
dc.titleImplementation of a Clinical Decision Support Tool to Aid Wound Infection Identification
dc.typeThesis
dcterms.abstractInfection is a potential wound complication causing a failure to progress through the predicted phases of healing resulting in a chronic wound. Early detection and intervention can help to restore the expected wound resolution trajectory to mitigate negative economic and psychosocial patient impacts. The use of algorithms or clinical decision support tools help to promote consistent and standardized care among clinicians with varying levels of expertise. Although clinical signs as indicators of infection are well accepted as conceptual models, a bedside tool has not yet been validated. A clinical decision support tool was developed for home care nurses to augment the standard weekly wound assessment to aid in the detection of patient and wound characteristics suggesting high risk of wound infection. Nurses participated in an educational in-service on the purpose and use of the clinical decision support tool followed by a 30-day field trial period. Knowledge assimilation was assessed pre and post tool implementation using digital images and case studies to compare the percentage of nurses who could accurately identify infection characteristics. Nurses answered a 7-item Likert survey to address tool satisfaction. No significant difference was found when examining the nurses’ ability to characterize all infection characteristics using the clinical decision support tool although significant improvements in correct responses were observed in the individual items for patient characteristics, wound age, and drainage amount (p<0.05). The combined number of nurse responses who felt the tool was useful was greater 81 percent compared to 12 percent and easy to use 85 percent versus 8 percent. This quality improvement project was supported by literature recommendations highlighting the positive benefits of a clinical decision support tool to promote standardized wound management. Better wound care processes are necessary to reduce inaccuracy and variability, improve efficiency, and avoid mismanagement. If nurses are better able to identify potentially infected wounds it could be inferred that patients will receive earlier intervention resulting in improved wound outcomes. Additional collaborative learning events with nursing staff may improve bedside identification of wound characteristics especially with novice nurses. To facilitate tool sustainability, assessment items can be built into the current electronic wound record prompting consistent use and enabling data extraction to allow for future tool validation.
dcterms.extent57 pages
dcterms.languageen
dcterms.publisherUniversity of Hawai'i at Manoa
dcterms.rightsAll UHM dissertations and theses are protected by copyright. They may be viewed from this source for any purpose, but reproduction or distribution in any format is prohibited without written permission from the copyright owner.
dcterms.typeText
local.identifier.alturihttp://dissertations.umi.com/hawii:11483

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