ArticleApplied clinical informatics2014
Developing clinical decision support within a commercial electronic health record system to improve antimicrobial prescribing in the neonatal ICU.
Article in Applied clinical informatics, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 14 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Improving Antimicrobial Prescribing Practices in the Neonatal Intensive Care Unit
Communicating Narrative Concerns Entered by RNs (CONCERN) Clinical Decision Support (CDS) System
Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Using electronic health record audit logs to study clinical activity: a systematic review of aims, measures, and methods.Journal of the American Medical Informatics Association : JAMIA · 2020Pooled it
- The effectiveness of computerised decision support on antibiotic use in hospitals: A systematic review.PloS one · 2017Pooled it
- Article
- A Measurement Science Framework to Optimize CDS for Opioid Use Disorder Treatment in the ED.Applied clinical informatics · 2025Article
- A systematic review of clinicians' acceptance and use of clinical decision support systems over time.NPJ digital medicine · 2025Article
- Clinical Decision Support Tool to Promote Adoption of New Neonatal Hyperbilirubinemia Guidelines.Applied clinical informatics · 2024Article
- Bridging the Gap: Exploring Bronchopulmonary Dysplasia through the Lens of Biomedical Informatics.Journal of clinical medicine · 2024Review
- Changes in perceptions of antibiotic stewardship among neonatal intensive care unit providers over the course of a learning collaborative: a prospective, multisite, mixed-methods evaluation.Journal of perinatology : official journal of the California Perinatal Association · 2024Article
- The development and implementation of a guideline-based clinical decision support system to improve empirical antibiotic prescribing.BMC medical informatics and decision making · 2022Article
- Implementation and impact of pediatric antimicrobial stewardship programs: a systematic scoping review.Antimicrobial resistance and infection control · 2020Article
- Clinical Decision Support Systems and Their Role in Antibiotic Stewardship: a Systematic Review.Current infectious disease reports · 2019Article
- Computerized Physician Order Entry in the Neonatal Intensive Care Unit: A Narrative Review.Applied clinical informatics · 2019Review
- Evaluating a handheld decision support device in pediatric intensive care settings.JAMIA open · 2019Article
- Combining expert knowledge and knowledge automatically acquired from electronic data sources for continued ontology evaluation and improvement.Journal of biomedical informatics · 2015Article
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
objectiveTo develop and implement a clinical decision support (CDS) tool to improve antibiotic prescribing in neonatal intensive care units (NICUs) and to evaluate user acceptance of the CDS tool.
methodsFollowing sociotechnical analysis of NICU prescribing processes, a CDS tool for empiric and targeted antimicrobial therapy for healthcare-associated infections (HAIs) was developed and incorporated into a commercial electronic health record (EHR) in two NICUs. User logs were reviewed and NICU prescribers were surveyed for their perceptions of the CDS tool.
resultsThe CDS tool aggregated selected laboratory results, including culture results, to make treatment recommendations for common clinical scenarios. From July 2010 to May 2012, 1,303 CDS activations for 452 patients occurred representing 22% of patients prescribed antibiotics during this period. While NICU clinicians viewed two culture results per tool activation, prescribing recommendations were viewed during only 15% of activations. Most (63%) survey respondents were aware of the CDS tool, but fewer (37%) used it during their most recent NICU rotation. Respondents considered the most useful features to be summarized culture results (43%) and antibiotic recommendations (48%). DISCUSSION: During the study period, the CDS tool functionality was hindered by EHR upgrades, implementation of a new laboratory information system, and changes to antimicrobial testing methodologies. Loss of functionality may have reduced viewing antibiotic recommendations. In contrast, viewing culture results was frequently performed, likely because this feature was perceived as useful and functionality was preserved.
conclusionTo improve CDS tool visibility and usefulness, we recommend early user and information technology team involvement which would facilitate use and mitigate implementation challenges.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.