Automation in nursing decision support systems

Decision Support Systems (DSS) are tools that analyse available data to guide evidence-based decision making of nurses. These systems can facilitate the nursing care process which is a globally implemented care framework that allows nurses to structure their decision making and care planning. Although DSS are widely used in nursing, the effect of automation within them is understudied.

The goals of this project are:

1. To understand nurses’ perceptions about current workflow and related DSS for two priority nursing-focussed, patient safety issues: falls and pressure injuries.
2. To evaluate the effects of automating human information processing functions within DSS on outcomes of falls and pressure injury risk assessments.

We conducted a systematic review to understand which steps of nursing care process are supported by existing DSS and analyse effects of automated information processing on decision making, care delivery and patient outcomes. We found that current nursing DSS improved compliance with recommendations and reduced decision time, but their impacts were not always sustainable. There were also improvements in evidence-based practice but overall impact on patient outcomes was mixed.  Most importantly, the review found that these DSS have limited automation.

We also interviewed registered nurses, patient safety officers, and nurse managers to explore their perceptions of risk assessment tools for falls and pressure injuries. We chose these two problems because they are on top of the list of hospital acquired complications in Australia and they are mainly managed by nurses. We found several challenges in the risk assessment process, with lack of automation in DSS being one of them.

Following up on outcomes of our systematic review and interviews, we designed a simulated DSS called Smart Nursing Assessment Program (SNAP). It is an intelligent DSS that can read and analyse all patient information, and help nurses prioritize and complete individual patient assessments. We plan to test SNAP with nurses to see if the automation has an impact on their decisions about risk assessment.