CC BY 4.0 · ACI open 2021; 05(02): e84-e93
DOI: 10.1055/s-0041-1736470
Original Article

A Clinical Decision Support System Design Framework for Nursing Practice

Sheng-Chieh Lu
1  Department of Symptom Research, University of Texas MD Anderson Cancer Center, Houston, Texas, United States
Rebecca J. Brown
2  School of Nursing, University of Minnesota, Minneapolis, Minnesota, United States
Martin Michalowski
2  School of Nursing, University of Minnesota, Minneapolis, Minnesota, United States
› Author Affiliations
Funding The authors also acknowledge the financial support from the Office of the Vice President for Research, University of Minnesota Grant-in-Aid. The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agency.


Background As nurses increasingly engage in decision-making for patients, a unique opportunity exists to translate research into practice using clinical decision support systems (CDSSs). While research has shown that CDSS has led to improvements in patient outcomes and nursing workflow, the success rate of CDSS implementation in nursing is low. Further, the majority of CDSS for nursing are not designed to support the care of patients with comorbidity.

Objectives The aim of the study is to conceptualize an evidence-based CDSS supporting complex patient care for nursing.

Methods We conceptualized the CDSS through extracting scientific findings of CDSS design and development. To describe the CDSS, we developed a conceptual framework comprising the key components of the CDSS and the relationships between the components. We instantiated the framework in the context of a hypothetical clinical case.

Results We present the conceptualized CDSS with a framework comprising six interrelated components and demonstrate how each component is implemented via a hypothetical clinical case.

Conclusion The proposed framework provides a common architecture for CDSS development and bridges CDSS research findings and development. Next research steps include (1) working with clinical nurses to identify their knowledge resources for a particular disease to better articulate the knowledge base needed by a CDSS, (2) develop and deploy a CDSS in practice using the framework, and (3) evaluate the CDSS in the context of nursing care.

Protection of Human and Animal Subjects

This study was deemed exempt by the University Institutional Review Board.

Authors' Contribution

M.M. and S.-C.L. contributed toward conception and design; M.M. provided financial support. All the authors collected and analyzed the data, drafted and approved the manuscript.

Publication History

Received: 10 December 2020

Accepted: 02 September 2021

Publication Date:
05 November 2021 (online)

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany