Perceived barriers of heart failure nurses and cardiologists in using clinical decision support systems in the treatment of heart failure patients

From Clinfowiki
Jump to: navigation, search

The following is a review of the article, “Perceived Barriers of Heart Failure Nurse and Cardiologists in using Clinical Decision Support Systems in the Treatment of Heart Failure Patients" [1].


One of the health problems that is related to aging is heart failure. Inadequate care of elderly patients with heart failure increases the chances of frequent hospital re-admissions and mortality rate (de Vries, van der Wal, Nieuwenhuis, de Jong, van Dijk, Jaarsma, Hillege, & Jorna, 2013, p. 1). The authors believe that the use of clinical decision support systems CDSS may help cardiac nurses and cardiologists prevent frequent hospital re-admissions and decrease mortality rate in elderly patients with history of heart failure. The authors believe that cardiac nurses and cardiologists are not utilizing the CDSS because of perceived barriers associated with the implementation of CDSS in the treatment of heart failure patients and the lack of knowledge and management of Clinical Decision Support System (CDSS).


The authors developed a questionnaire that “consists of 49 items, focusing on perceived barriers using a 5-point Likert type rating scale” (de Vries et al., 2013, p. 2). Because the authors were based in the Netherlands, the questionnaires were sent to heart failure clinics in the Netherlands. The questionnaires were answered by 36 cardiologists and 126 cardiac nurses. 30% of the questionnaire responders had experience in working with CDSS because they used telemonitoring systems that had CDSS functions.


The authors were able to conclude that for cardiologists, factors such as age, gender, and experience with computers were not a barrier in the implementation of CDSS. However, for cardiac nurses, experiences with computers were a strong barrier in the implementation of CDSS. The authors suggested that clinicians increase their training of the functions of CDSS in order to gain more experience with CDSS. This will lead the clinicians to develop stronger knowledge and management skills of the functions of CDSS. With more experience with the CDSS, there will be fewer barriers with CDSS.


This article serves as a good guidance in teaching the importance of training staffers well when implementing CDSS. It can be a powerful tool, however, when there are barriers against it, it becomes limited in its potential. Continual training on the functions of CDSS is one way to make the user experience more effective. Other studies suggest that use of human factors design principles may improve receptiveness to alerts.


  1. de Vrie, A., van der Wal, M., Nieuwenhuis, M., de Jong, R., van Dijk, R., Jaarsma, T., Hillege, H., & Jorna, R. (2013). Perceived barriers of heart failure nurses and cardiologists in using clinical decision support systems in the treatment of heart failure patients. BMC Medical Informatics and Decision Making, 13(54), 1-8