Dodson Crystal Heath, Baker Elizabeth, Bost Kirsten
School of Nursing, University of North Carolina at Wilmington, Wilmington, North Carolina.
Cameron School of Business, University of North Carolina at Wilmington, Wilmington, North Carolina.
J Am Assoc Nurse Pract. 2019 Sep;31(9):522-526. doi: 10.1097/JXX.0000000000000170.
An obstacle to clinical implementation of precision medicine is the absence of easily accessible peer-reviewed, comprehensive clinical practice guidelines. Therefore, an easily accessible format is needed to propel the adoption of these guidelines by healthcare providers. An understanding of the process providers take to prescribe medications will inform development of clinical decision support tools, specifically related to precision medicine. Successful use of mobile applications will depend on the buy-in from healthcare providers. The purpose of this study was to assess perceptions of trustworthiness surrounding clinical decision support tools and mobile applications through interviews with nurse practitioners.
A descriptive, qualitative research design was used. A sample of 10 nurse practitioners who actively prescribe medication was used within the study.
The participants mentioned both negative and positive attitudes regarding these prescribing techniques. Overall four themes emerged from this thematic analysis: the use of pharmacists to help with current prescribing practices, reliance on the EMR as a clinical decision support tool, lack of mobile app use in clinical practice, but the desire to have these resources if they were affordable and reliable.
The participants were aware of the use of mobile apps for clinical decision support, but the adoption of these tools was limited due to the perceived lack of affordability and reliability. Therefore, to overcome these barriers to adoption of a mobile app related to precision medicine, affordability and transparent construction of an app grounded in credible sources must be developed.
精准医疗临床应用的一个障碍是缺乏易于获取的、经过同行评审的全面临床实践指南。因此，需要一种易于获取的形式来推动医疗服务提供者采用这些指南。了解医疗服务提供者开药的过程将为临床决策支持工具的开发提供信息，特别是与精准医疗相关的工具。移动应用程序的成功使用将取决于医疗服务提供者的认可。本研究的目的是通过对执业护士的访谈来评估对临床决策支持工具和移动应用程序的可信度认知。
采用描述性定性研究设计。研究中使用了10名积极开药的执业护士作为样本。
参与者对这些开药技术既提到了消极态度也提到了积极态度。通过本次主题分析共出现了四个主题：利用药剂师协助当前的开药实践、依赖电子病历作为临床决策支持工具、临床实践中缺乏移动应用程序的使用，但如果这些资源价格合理且可靠则希望拥有。
参与者了解将移动应用程序用于临床决策支持，但由于认为缺乏可承受性和可靠性，这些工具的采用受到限制。因此，为克服与精准医疗相关的移动应用程序采用的这些障碍，必须开发出价格合理且基于可靠来源构建的透明应用程序。
