ArticleApplied clinical informatics2017
Developing Mobile Clinical Decision Support for Nursing Home Staff Assessment of Urinary Tract Infection using Goal-Directed Design.
Article in Applied clinical informatics, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.
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Who cites it
10 citing papers in PubMed, 2 syntheses or guidelines pooled it, 26 citations in OpenAlex.
- Optimizing Clinical Decision Support System Functionality by Leveraging Specific Human-Computer Interaction Elements: Insights From a Systematic Review.JMIR human factors · 2025Pooled it
- Stakeholder Perspectives of Clinical Artificial Intelligence Implementation: Systematic Review of Qualitative Evidence.Journal of medical Internet research · 2023Pooled it
- Nurse Decision-making for Suspected Urinary Tract Infections in Nursing Homes: Potential Targets to Reduce Antibiotic Overuse.Journal of the American Medical Directors Association · 2021Trial
- Impact of Urinary Tract and Vaginal Infections on the Physical and Emotional Well-being of Women.Infectious disorders drug targets · 2025Review
- Multitasking during Medication Management in a Nursing Home: A Time Motion Study.Applied clinical informatics · 2024Article
- Health Community 4.0: An Innovative Multidisciplinary Solution for Tailored Healthcare Assistance Management.Sensors (Basel, Switzerland) · 2024Article
- Nurses' Roles in mHealth App Development: Scoping Review.JMIR nursing · 2023Article
- [Support of treatment safety by nursing personnel when dealing with emergency situations in long-term care facilities : Results of a qualitative empirical study].Zeitschrift fur Gerontologie und Geriatrie · 2023Article
- Electronic Health Records in Danish Home Care and Nursing Homes: Inadequate Documentation of Care, Medication, and Consent.Applied clinical informatics · 2021Article
- Joint Design with Providers of Clinical Decision Support for Value-Based Advanced Shoulder Imaging.Applied clinical informatics · 2020Article
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundUnique characteristics of nursing homes (NHs) contribute to high rates of inappropriate antibiotic use for asymptomatic bacteriuria (ASB), a benign condition. A mobile clinical decision support system (CDSS) may support NH staff in differentiating urinary tract infections (UTI) from ASB and reducing antibiotic days.
objectivesWe used Goal-Directed Design to: 1) Characterize information needs for UTI identification and management in NHs; 2) Develop UTI Decide, a mobile CDSS prototype informed by personas and scenarios of use constructed from Aim 1 findings; 3) Evaluate the UTI Decide prototype with NH staff.
methodsFocus groups were conducted with providers and nurses in NHs in Denver, Colorado (n= 24). Qualitative descriptive analysis was applied to focus group transcripts to identify information needs and themes related to mobile clinical decision support for UTI identification and management. Personas representing typical end users were developed; typical clinical context scenarios were constructed using information needs as goals. Usability testing was performed using cognitive walk-throughs and a think-aloud protocol.
resultsFour information needs were identified including guidance regarding resident assessment; communication with providers; care planning; and urine culture interpretation. Design of a web-based application incorporating a published decision support algorithm for evidence-based UTI diagnoses proceeded with a focus on nursing information needs during resident assessment and communication with providers. Certified nursing assistant (CNA) and registered nurse (RN) personas were constructed in 4 context scenarios with associated key path scenarios. After field testing, a high fidelity prototype of UTI Decide was completed and evaluated by potential end users. Design recommendations and content recommendations were elicited.
conclusionsGoal-Directed Design informed the development of a mobile CDSS supporting participant-identified information needs for UTI assessment and communication in NHs. Future work will include iterative deployment and evaluation of UTI Decide in NHs to decrease inappropriate use of antibiotics for suspected UTI.
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