ArticleCritical care explorations2023
Facilitators and Barriers to Interacting With Clinical Decision Support in the ICU: A Mixed-Methods Approach.
Article in Critical care explorations, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 10 citations in OpenAlex.
- Barriers and facilitators for intensive care nurses in using clinical decision support systems for intravenous Y-site compatibility in intensive care: A survey study.International journal of nursing studies advances · 2026Article
- Deep learning models for acute kidney injury prediction: multi-center external validation and evaluation under simulated continuous monitoring conditions.NPJ digital medicine · 2026Article
- Beyond Human Error: Building Intelligent Resilience for Medication Safety in the ICU.Healthcare (Basel, Switzerland) · 2026Review
- User experience study to evaluate a clinical decision support system prototype supporting continuous kidney replacement therapy in a simulated ICU environment.BMC medical informatics and decision making · 2025Article
- Barriers and Facilitators to Artificial Intelligence Implementation in Diabetes Management from Healthcare Workers' Perspective: A Scoping Review.Medicina (Kaunas, Lithuania) · 2025Article
- Exploring intensive care unit nurses' acceptance of clinical decision support systems and use of volumetric pump data: A qualitative description study.Nursing in critical care · 2025Article
- Machine Learning for Targeted Advance Care Planning in Cancer Patients: A Quality Improvement Study.Journal of pain and symptom management · 2024Article
- Impact of automated pop-up alerts on simultaneous prescriptions of antimicrobial agents and metal cations.Journal of pharmaceutical health care and sciences · 2024Article
Corrections and comments
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Authors and funding
9 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesClinical decision support systems (CDSSs) are used in various aspects of healthcare to improve clinical decision-making, including in the ICU. However, there is growing evidence that CDSS are not used to their full potential, often resulting in alert fatigue which has been associated with patient harm. Clinicians in the ICU may be more vulnerable to desensitization of alerts than clinicians in less urgent parts of the hospital. We evaluated facilitators and barriers to appropriate CDSS interaction and provide methods to improve currently available CDSS in the ICU.
designSequential explanatory mixed-methods study design, using the BEhavior and Acceptance fRamework.
settingInternational survey study. PATIENT/SUBJECTS: Clinicians (pharmacists, physicians) identified via survey, with recent experience with clinical decision support.
interventionsAn initial survey was developed to evaluate clinician perspectives on their interactions with CDSS. A subsequent in-depth interview was developed to further evaluate clinician (pharmacist, physician) beliefs and behaviors about CDSS. These interviews were then qualitatively analyzed to determine themes of facilitators and barriers with CDSS interactions. MEASUREMENTS AND MAIN
resultsA total of 48 respondents completed the initial survey (estimated response rate 15.5%). The majority believed that responding to CDSS alerts was part of their job (75%) but felt they experienced alert fatigue (56.5%). In the qualitative analysis, a total of five facilitators (patient safety, ease of response, specificity, prioritization, and feedback) and four barriers (excess quantity, work environment, difficulty in response, and irrelevance) were identified from the in-depth interviews.
conclusionsIn this mixed-methods survey, we identified areas that institutions should focus on to improve appropriate clinician interactions with CDSS, specific to the ICU. Tailoring of CDSS to the ICU may lead to improvement in CDSS and subsequent improved patient safety outcomes.
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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.