ArticleApplied clinical informatics2024
Successfully Transitioning an Interruptive Alert into a Noninterruptive Alert for Central Line Dressing Changes in the Neonatal Intensive Care Unit.
Article in Applied clinical informatics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Designing a Clinical Decision Support Tool to Promote Timely Palliative Care in Heart Failure.medRxiv : the preprint server for health sciences · 2026Article
- Transitioning Ineffective Medications on Hold Alert from Interruptive to Noninterruptive Alert to Decrease Alert Burden.Applied clinical informatics · 2025Article
- Sisyphus' Alert: The Uphill Struggle to Improve Venous Thromboembolism Prophylaxis Clinical Decision Support.Applied clinical informatics · 2025Article
- The Elements of Style for Interruptive Electronic Health Record Alerts.Applied clinical informatics · 2025Article
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundInterruptive alerts are known to be associated with clinician alert fatigue, and poorly performing alerts should be evaluated for alternative solutions. An interruptive alert to remind clinicians about a required peripherally inserted central catheter (PICC) dressing change within the first 48 hours after placement resulted in 617 firings in a 6-month period with only 11 (1.7%) actions taken from the alert.
objectivesThis study aimed to enhance a poorly functioning interruptive alert by converting it to a noninterruptive alert aiming to improve compliance with the institutional PICC dressing change protocol. The primary outcome was to measure the percentage of initial PICC dressing changes that occurred beyond the recommended 48-hour timeframe after PICC placement. Secondary outcomes included measuring the time to first dressing change and, qualitatively, if this solution could replace the manual process of maintaining a physical list of patients.
methodsA clinical informatics team met with stakeholders to evaluate the clinical workflow and identified an additional need to track which patients qualified for dressing changes. A noninterruptive patient column clinical decision support (CDS) tool was created to replace an interruptive alert. A pre-postintervention mixed-methods cohort study was conducted between January 2022 and November 2022.
resultsThe number of patients with overdue PICC dressing changes decreased from 21.9% (40/183) to 7.8% (10/128) of eligible patients (
conclusionWhile previous studies have reported that noninterruptive CDS may not be as effective as interruptive CDS, this case report demonstrates that developing a population-based CDS in the patient list column that provides an additional desired functionality to clinicians may result in improved adoption of CDS.
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