Clinical Decision Support

[nkochrn, RN]

I'm interested in seeing what everyone is using for their clinical decision support rules.

I've been working on one this morning:

• Recommend HGBA1C on all patients admitted with diabetes that have not had one checked in the past year.
  

Here's a couple more I've seen:

• If HGBA1C > 7.0 and pt. not on any oral hypoglycemics, prompt to order Metformin
  
• If >65 y/o and no record of pneumovax, prompt to order this
  
• If >18 y/o and not record of pap smear for last 12 months, prompt to schedule and discharge
  

One of the problems I have with this is that HIM is not concurrently coding, so if the CDS requires a diagnosis before it will trigger then it doesn't do much good b/c the diagnosis will not be in. I may have a REALLY hard time getting nursing to enter the patient diagnosis into the patient's problem list, but if I can get them to do at least that, then it would help.