Nursing 6004 Module 5 Blog Entry

Reviewing the readings for this week did make me thing about how I make decisions as a nurse. I had actually never heard of the CDS software and found it really interesting. I reviewed the DXplain software and wish that I worked at a place that used it, as I think that it would be extremely helpful, especially as a student. I think that for medical practice, having electronic databases and CDS software can help the practitioner to make informed decisions and help them to consider other options that they may have otherwise missed.

One thing that I have used that related to this module's readings is a DSM psychiatric database that we have available at the state hospital. It is a website that has links to research articles on various psych disorders and I've used it to look up evidence based practice guidelines for certain disorders. However, it is not as detailed as the DXplain software and does not give you a diagnosis based on symptoms.

Where I work in psychiatry, I don't think that the CDS software would be as helpful. A lot of times, psych diagnoses don't fit into a prepackaged box of symptoms. Even the DSM IV has a hard time categorizing certain disorders, and there is a lot of overlap. There also is so much subjectivity in psych, there is not a lab or diagnostic test to confirm diagnoses. The practitioner sometimes has to make the best guess possible, as far as what is going on clinically with the patient, and many times the patient isn't able to tell them the problem (for example, an acutely psychotic patient).  I found myself trying to think how a CDS software program could help us in psych, perhaps it could be used with medication selection or to help when there are several diagnoses that the practitioner is considering. Ultimately though, psych seems to be more a mix of art and science, requiring the practitioner to think outside the box at times, and make the best guess possible on limited information.