ABSTRACTUtilization of clinical decision support tools by nurse practitioners ensures up-to-date and evidence-based information, which is designed to foster improved patient outcomes. In urgent care at the University of Utah, there are a number of electronic databases that are made available to staff from which to choose when searching for the most relevant treatment information. The purpose of this project is to elaborate on those tools, highlight the importance of each tool, and help the practitioner choose the most efficient tool when forming a treatment plan. The project also outlines a plan for implementation and presentation of a decision flowchart that helps identify the support tools and determine which to use.

PICO QUESTIONDo nurse practitioners in urgent care that follow an algorithmic process of investigating the most up-to-date information regarding treatment improve patient care in comparison with those that use a less structured process?

LITERATURE REVIEWThe literature review is organized into three main components: ● Determining a definition of clinical decision

support (CDS) tools● Comparing CDS tools● The differences between the academic's

perspective of evidence-based practice and the clinician's perspective of evidence-based practice.

The literature review compares the usefulness of seven software tools that support the provider in the decision-making process, promoting best patient outcomes.

A Standardized Process for Investigating Current Clinical Evidence for Treating Urgent Care PatientsDonner Schweitzer, MSN, RN, MSNP Student

Plan and Implementation● Roundtables are meetings in which the

providers discuss current issues within urgent care. This will serve as a platform for implementation.

● The presentation will consist of a pre-questionnaire that the providers will complete during the meeting and a 20-minute discussion of the project.

● Problems addressed include accessing information timely and retrieving relevant information with the best evidence.

● Provider buy-in is essential in this process, and to be effective in its implementation, providers need to be invested in best practice that is most up to date.¹

Clinical Decision Software Tools• UpToDate• Epocrates• Dynamed• Lexicomp• Micromedex• Visual Dx• Google Scholar

THEORETICAL FRAMEWORK• This project uses the theoretical framework of

Lewin’s change theory to help support the benefits of best clinical practice and the need for change on a fundamental level within health care to ensure best practice for clinicians and better outcomes for patients.

• Lewin's model uses three basic steps to overcome the hurdle of change: unfreezing, moving or transitioning, and refreezing². Lewin's change theory focuses on the need to create the motivation for change (unfreezing). This can be in the form of a provider identifying a practice that needs to be improved. The second step engages the stakeholders by providing a thorough plan for the change event. The third step involves "institutionalizing" the change and creating a standard for care².

CONCLUSIONSAchievements of the project include

● Provided a deeper understanding of the clinical decision software tools that are available within the University of Utah urgent care clinics,

● Promoted extensive discussion and collaboration among providers, and

● Implemented a better approach to using clinical decision software tools in practice.

Patient care is not a one size fits all approach. In addition, algorithms are an excellent way to standardize care while still allowing the provider to care for the individual patient in the safest way.

REFERENCES1. Seers, K., Cox, K., Crichton, J., Edwards, T., Eldh, C., Estabrooks, C., & Wallin, L. (2012).

FIRE (Facilitating Implementation of research evidence): A study protocol. Implementation Science, 7(25). doi:10.1186/1748-5908-7-25

2. Cummings, S., Bridgman, T., & Brown, K. (2016). Unfreezing change as three steps: Rethinking Kurt Lewin’s legacy for change management. Human Relations, 69(1), 33-60.

PROJECT METHODOLOGY

The MSN Project focuses on a clinical decision-making tool that enables new providers to follow a flowchart when determining the most up-to-date plan of care for the patient in urgent care. The project deliverables are as follows: pre-questionnaire, the decision support flowchart, presentation at roundtable for providers in urgent care, and the post-questionnaire. The purpose of the MSN Project is to design a flowchart tool that will utilize the most up-to-date evidence to report on the available clinical decision software for providers at the University of Utah and determine what software is most appropriate in specific clinical situations. In addition, the Lewin’s change theory will guide processes in the project.

Evaluation• The plan for evaluation of project will be

largely framed by the post-questionnaire. Providers will provide feedback to help evaluate the effectiveness of the tool. The information gained from the post-questionnaire will be compared with the information gathered from the pre-questionnaire.

DDecision Making Flowchart

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