Université de Lorraine, Inserm, INSPIIRE, F-54000 Nancy, France; Université de Lorraine, CHRU-Nancy, Service d'Odontologie, F-54000 Nancy, France.
Université de Lorraine, Inserm, INSPIIRE, F-54000 Nancy, France.
Int J Med Inform. 2024 Dec;192:105653. doi: 10.1016/j.ijmedinf.2024.105653. Epub 2024 Oct 12.
Antimicrobial stewardship (AMS) programs aim to optimize antibiotic use through a panel of interventions. The implementation of computerized clinical decision support systems (CDSSs) offers new opportunities for semiautomated antimicrobial review by AMS teams. This study aimed to evaluate the perceived facilitators, barriers and benefits of end-users related to a commercial CDSS recently implemented in a hospital and to assess its usability.
A mixed-method approach was used among AMS team members nine months after the implementation of the CDSS in a university hospital in northeastern France. A qualitative analysis based on individual semistructured interviews was conducted to collect end-users' perceptions. A quantitative analysis was performed using the System Usability Scale (SUS).
Eleven AMS team members agreed to participate. The qualitative analysis revealed technical, organizational and human barriers and facilitators of CDSS implementation. Effective collaboration with information technology teams was crucial for ensuring the installation and configuration of the software. CDSS adoption by the AMS team required time, human resources, training, adaptation and a clinical leader. Moreover, the CDSS had to be well designed, user-friendly and provide benefits to AMS activities. The quantitative analysis indicated that the CDSS was a "good" system in terms of perceived ease of use (median SUS score: 77.5/100).
This study shows the value of the studied CDSS to support AMS activities. It reveals barriers, facilitators and benefits to the implementation and adoption of the CDSS. These barriers and facilitators could be considered to facilitate the implementation of the software in other hospitals.
抗菌药物管理（AMS）计划旨在通过一系列干预措施优化抗生素的使用。计算机临床决策支持系统（CDSS）的实施为 AMS 团队提供了半自动化抗菌药物审查的新机会。本研究旨在评估与最近在一家医院实施的商业 CDSS 相关的最终用户的感知促进因素、障碍和益处，并评估其可用性。
在法国东北部的一家大学医院实施 CDSS9 个月后，采用混合方法对 AMS 团队成员进行研究。通过对 11 名 AMS 团队成员的半结构化访谈进行定性分析，收集最终用户的认知。使用系统可用性量表（SUS）进行定量分析。
11 名 AMS 团队成员同意参与。定性分析揭示了 CDSS 实施的技术、组织和人为障碍和促进因素。与信息技术团队的有效合作对于确保软件的安装和配置至关重要。AMS 团队采用 CDSS 需要时间、人力资源、培训、适应和临床领导者。此外，CDSS 必须设计良好、用户友好，并为 AMS 活动提供益处。定量分析表明，就感知易用性而言，该 CDSS 是一个“良好”的系统（中位 SUS 得分：77.5/100）。
本研究表明，所研究的 CDSS 对支持 AMS 活动具有价值。它揭示了 CDSS 实施和采用的障碍、促进因素和益处。这些障碍和促进因素可被视为在其他医院实施该软件的便利条件。
