RePub, Erasmus University Repository: Implementation of clinical decision support in you

Acute gastroenteritis (AGE) is one of the most frequent reasons for young children to visit emergency departments (EDs). We aimed to evaluate (1) feasibility of a nurse-guided clinical decision support system for rehydration treatment in children with AGE and (2) the impact on diagnostics, treatment, and costs compared with usual care by attending physician. A randomized controlled trial was performed in 222 children, aged 1 month to 5 years at the ED of the Erasmus MC-Sophia Children’s hospital in The Netherlands ( 2010–2012). Outcome included (1) feasibility, measured by compliance of the nurses, and (2) length of stay (LOS) at the ED, the number of diagnostic tests, treatment, follow-up, and costs. Due to failure of post-ED weight measurement, we could not evaluate weight difference as measure for dehydration. Patient characteristics were comparable between the intervention (N = 113) and the usual care group (N = 109). Implementation of the clinical decision support system proved a high compliance rate. The standardized use of oral ORS (oral rehydration solution) significantly increased from 52 to 65%(RR2.2, 95%CI 1.09–4.31 p < 0.05). We observed no differences in other outcome measures. Conclusion: Implementation of nurse-guided clinical decision support system on rehydration treatment in children with AGE showed high compliance and increase standardized use of ORS, without differences in other outcome measures.(Table presented.)

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doi.org/10.1007/s00431-016-2819-2, hdl.handle.net/1765/94819
European Journal of Pediatrics
Erasmus MC: University Medical Center Rotterdam

Geurts, D., De Vos-Kerkhof, E., Polinder, S., Steyerberg, E., van der Lei, J., Moll, H., & Oostenbrink, R. (2017). Implementation of clinical decision support in young children with acute gastroenteritis: A randomized controlled trial at the emergency department. European Journal of Pediatrics, 176(2), 173–181. doi:10.1007/s00431-016-2819-2
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