Describe the ethical dilemma with associated relevant facts

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Reference no: EM133918657

Case study

James is a nurse in the Cardiothoracic Intensive Care unit (CICU), where a new EHR system was integrated 3 months ago, including the CDSSs (Clinical Decision Support Systems) to support common clinical decisions and activities within the CICU. CDSSs and their alerts are offered for drug dosage calculations, potential drug/drug interactions, lab values, drug-allergy interactions, and others. While James tries to address each alert as it arises, he finds the frequent alerts to be an increasing source of frustration, leading him to identify mechanisms to circumvent the CDSSs, and override the alert system. For example, the CDSSs trigger alerts regarding the use of nephrotoxic medications in all patients, regardless of their renal function. In caring for a patient during one shift, James overrides the alert for a patient who is scheduled to receive tobramycin, an aminoglycoside antibiotic associated with a risk for nephrotoxicity. He does not review the patient's labs related to renal function before giving the dose of medication, and as a result the patient's renal function declines quickly, leading to a nephrology consult for possible dialysis. Fortunately, the patient's renal function returns to normal ranges several hours later, but James is worried that a similar patient-care situation could occur in the future.

1. Describe the ethical dilemma with associated relevant facts that occurs in this case study.

2. Discuss possible alternatives that could apply to the situation, with pros and cons.

3. Identify strategies that could be implemented within the design of the CDSS rules in the EHR system to minimize alert fatigue.

4. Discuss how the informatics nurse could contribute to prevention of this type of issue.

5. Should providers be able to customize alerts for their clinical needs? Why or why not?

Reference no: EM133918657

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