There are several parameters that need to be considered when making rules for flowcharts designed to be used. The first is whether it is applicable to the group targeted and whether it can be answered with a yes/no response by the entire target population. The second parameter that must be considered is the applicability of that rule to the context, which in this case is smoking cessation. Another parameter that might be useful to consider is how well the rule answers the questions that need to be answered to make a diagnosis of the relevant condition (Adsit & Fiore, 2013).
In this case, all the rules are triggered by the result of the last question. There are examples whereby no smoking cessation support is needed, which brings the flowchart to an end as there is no meaningful data to be gathered from the answer with respect to this population (HealthIT.Gov, n.d.). This is a useful way of excluding populations that need to be excluded.
The main filter useful for this flowchart is whether the patient is a current smoker. This needs to be considered as smoking cessation support is, obviously, not necessary for patients that do not currently smoke (NJ-HIEC, n.d.). Another filter is whether the patient has their smoking status recorded as recommended by current guidelines (NJ-HIEC, n.d.).
The actions of this flowchart depend on how it is used and the result of the patient. It would be useful to have a pop-up message appear if the individual needs to have smoking cessation support, which could also contain the numbers of people that can be contacted to provide this support.
Narrative
One of the biggest challenges when completing this CDS activity was working out how to display the flowchart in a meaningful way that would be useful for practitioners. This is a challenge because there are sometimes tangential questions that need to be addressed, but would challenge the usability of the flowchart (NJ-HIEC, n.d.). This can be addressed by ensuring that the questions asked are all answerable with yes/no responses, and that they are relevant to the issue being examined by the flowchart. Another challenge was ensuring that smoking cessation support was offered to all patients that needed it per the rules of the flowchart. This is vital because the flowchart is designed to ensure that practitioners are aware that the patient needs smoking cessation support as part of their care. If some smokers are not being offered the support, then the flowchart has failed. Overall, this process required a lot of research which made it challenging but informative. It was an interesting assignment to complete as I learnt more about nursing informatics and had to refer to Saba & McCormick (2016) several times to ensure that I was completing the assignment right. I would like the opportunity to go through the process again with an issue that is more relevant to my own area of practice, but this assignment gave me an opportunity to develop the skills that I will need to do this later.
- Adsit, R., & Fiore, M. (2013). Assessing tobacco use: The national landscape August 2013. Retrieved from http://www.ctri.wisc.edu/documents/tobusenational2013.pdf
- HeatlhIT.Gov. (n.d.). Step 5: Achieve meaningful use stage 1. Retrieved from
- NJ-HIEC. (n.d.). Clinical decision support rule. Retrieved from http://www.njhitec.org/index.php/meaningful-use/stage-1/core-objectives/clinical-decision-support-rule/
- Saba, V. K., & McCormick, K. (Eds.). (2015). Essentials of Nursing Informatics, 6th Edition (6 edition). New York: McGraw-Hill Education / Medical.
