Barriers and facilitators for intensive care nurses in using clinical decision support systems for intravenous Y-site compatibility in intensive care: A survey study.

Background: Patients in intensive care units frequently receive multiple intravenous medications, increasing the risk of medication errors, including incompatible Y-site drug co-administration. Drug incompatibility can lead to serious clinical consequences, yet evidence supporting the safety of many commonly co-administered drug combinations is limited. Clinical decision support systems may help reduce medication errors and improve patient care, but challenges remain in their design and adaptation to complex and dynamic clinical settings such as the intensive care unit.The Swedish Y-site compatibility system was developed by pharmacists and, it is a website that enables users to assess potential Y-site compatibility between intravenously administered drug pairs. However, the website was not specifically designed for intensive care setting, where the need for this information is greatest. Objective: To identify barriers and facilitators influencing intensive care nurses' use of clinical decision support systems to enhance the safety of drug administration, with a focus on the Swedish Y-site Compatibility System. Methods: A digital survey, inspired by the BEhavior and Acceptance fRamework (BEAR), was distributed to all 296 intensive care unit nurses in clinical service at an intensive care unit at a large University Hospital in Sweden. The survey included respondent characteristics, intravenous drug administration practices, general perceptions of clinical decision support systems, and attitudes towards the Swedish Y-site compatibility system. Results: A total of 126 intensive care unit nurses (43%) responded to the survey. Among them, 67% reported administering intravenous medications without knowing if they are compatible when co-administered intravenously, and 18% reported performing such administration at least weekly. Most respondents (89%) used the Swedish Y-site compatibility system, and 82% would recommend it to others. No apparent barrier was identified among the surveys areas; social factors, clinical context, and implementation by assessing nurses' perceptions, intravenous drug administration practices, and specific feedback on the Swedish Y-site compatibility system. Identified facilitators included the perceived value of clinical decision support systems in improving intravenous medication administration and patient care. Conclusions: Intensive care unit nurses reported positive views regarding clinical decision support systems, and the Swedish Y-site compatibility system was regarded as a valuable tool in supporting safer intravenous medication administration. Despite widespread use, many nurses still administer intravenous drugs without knowing its compatibility, indicating ongoing risk and a need for targeted education, and further development of the Swedish Y-site compatibility system to tailor it to the intensive care unit setting. Registration: Not registered.