Embedding Policy and Procedure Hyperlinks Into the Electronic Health Record to Improve Practice, Usability, and Reduce the Risk of Litigation.

PURPOSE: The purpose of this study was to evaluate the effects of implementing clinical decision support (embedded organizational policy and procedure hyperlinks) within intuitive areas of an electronic health record used by nurses. DESIGN: An interrupted time series design was used in this study. METHODS: Performance testing to determine usability was conducted prior to and following the implementation of two embedded policy and procedure hyperlinks. FINDINGS: Improvement in all three components of usability (efficiency, effectiveness, and satisfaction) was found following the implementation of the hyperlinks. Nurses were not able to recall critical elements of the policy and procedures. CONCLUSIONS: Nurses did not have satisfactory memory recall for policy and procedures and needed access to ensure compliance. Embedding policy and procedure hyperlinks into the electronic health record improved access and usability.

A Randomized Controlled Trial to Compare Pain Medications in Children Undergoing Strabismus Surgery.

PURPOSE: The purpose of this study was to investigate optimal intraoperative combinations of analgesia for children undergoing strabismus surgery. DESIGN: A randomized controlled trial was employed to compare the difference in pain after administration of hydromorphone versus fentanyl. METHODS: Participants were randomly assigned to either arm of the study. Pain was measured by the revised Faces, Legs, Activity, Cry, and Consolability Scale (rFLACC) tool postoperatively, and the parent was asked about the presence or absence of pain after discharge. FINDINGS: A total of 135 children were included in the study. The rFLACC pain score was found to be significantly higher postoperatively among patients receiving fentanyl (P = .011). Pain after discharge was reported more often among patients who received fentanyl (P < .001). CONCLUSIONS: Results of this study can be used to change practice to minimize the pain levels both postoperatively and after discharge for children undergoing strabismus surgery.