Development and implementation of a clinical information system-based protocol to improve nurse satisfaction of end-of-life care in a single intensive care unit

The Effect of Clinical Decision Support Systems on Patients, Nurses, and Work Environment in ICUs: A Systematic Review

This study aimed to examine the impact of clinical decision support systems on patient outcomes, working environment outcomes, and decision-making processes in nursing. The authors conducted a systematic literature review to obtain evidence on studies about clinical decision support systems and the practices of ICU nurses. For this purpose, the authors searched 10 electronic databases, including PubMed, CINAHL, Web of Science, Scopus, Cochrane Library, Ovid MEDLINE, Science Direct, Tr-Dizin, Harman, and DergiPark. Search terms included "clinical decision support systems," "decision making," "intensive care," "nurse/nursing," "patient outcome," and "working environment" to identify relevant studies published during the period from the year 2007 to October 2022. Our search yielded 619 articles, of which 39 met the inclusion criteria. A higher percentage of studies compared with others were descriptive (20%), conducted through a qualitative (18%), and carried out in the United States (41%). According to the results of the narrative analysis, the authors identified three main themes: "patient care outcomes," "work environment outcomes," and the "decision-making process in nursing." Clinical decision support systems, which target practices of ICU nurses and patient care outcomes, have positive effects on outcomes and show promise in improving the quality of care; however, available studies are limited.

Factors associated with healthcare providers' satisfaction with end-of-life care in the intensive care unit: A systematic review

BACKGROUND

We aimed to synthesize published data on and identify factors associated with healthcare providers' satisfaction with end-of-life care for critically ill adults.

METHODS

Electronic databases were searched from inception to January 23, 2023. We included trials involving adults admitted to intensive care units (ICUs) or high-dependency units to evaluate palliative care interventions.

STUDY SELECTION

The inclusion criteria were as follows: 1) Adult patients (age ≥18 years) or their family members admitted to the ICU or a high-dependency unit; 2) ICU palliative care interventions; 3) Randomized and non-randomized controlled trials; and 4) Full-text, peer-reviewed articles published in English. Two reviewers screened and extracted the data and assessed bias risk. The primary outcome was an improvement in the healthcare providers' satisfaction based on the validated scales.

RESULTS

Out of 12 studies, 9 investigated combined dimension intervention. Healthcare providers' satisfaction improved in 6/7 (85.7%) of the studies testing educational intervention, 5/7 (71.4%) studies testing the effectiveness of palliative care team involvement, 4/5 (80%) of studies testing communication interventions, while 0/2 (0%) study testing ethic consultations.

CONCLUSIONS

Most of the tested palliative care interventions were associated with improved healthcare provider satisfaction in intensive care units. The impacts of such intervention on mental health and burden remain to be investigated in this field.