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Thematic analysis of nurse practitioners use of clinical decision support tools and clinical mobile apps for prescriptive purposes

Dodson, Crystal Heath PhD, RN, MSN, BC-ADM, CNE (Assistant Professor)1; Baker, Elizabeth PhD (Assistant Professor)2; Bost, Kirsten RN (Research Assistant)3

Journal of the American Association of Nurse Practitioners: September 2019 - Volume 31 - Issue 9 - p 522–526
doi: 10.1097/JXX.0000000000000170
Research - Qualitative

Background and purpose: An obstacle to clinical implementation of precision medicine is the absence of easily accessible peer-reviewed, comprehensive clinical practice guidelines. Therefore, an easily accessible format is needed to propel the adoption of these guidelines by healthcare providers. An understanding of the process providers take to prescribe medications will inform development of clinical decision support tools, specifically related to precision medicine. Successful use of mobile applications will depend on the buy-in from healthcare providers. The purpose of this study was to assess perceptions of trustworthiness surrounding clinical decision support tools and mobile applications through interviews with nurse practitioners.

Methods: A descriptive, qualitative research design was used. A sample of 10 nurse practitioners who actively prescribe medication was used within the study.

Conclusions: The participants mentioned both negative and positive attitudes regarding these prescribing techniques. Overall four themes emerged from this thematic analysis: the use of pharmacists to help with current prescribing practices, reliance on the EMR as a clinical decision support tool, lack of mobile app use in clinical practice, but the desire to have these resources if they were affordable and reliable.

Implications for practice: The participants were aware of the use of mobile apps for clinical decision support, but the adoption of these tools was limited due to the perceived lack of affordability and reliability. Therefore, to overcome these barriers to adoption of a mobile app related to precision medicine, affordability and transparent construction of an app grounded in credible sources must be developed.

1School of Nursing, University of North Carolina at Wilmington, Wilmington, North Carolina

2Cameron School of Business, University of North Carolina at Wilmington, Wilmington, North Carolina

3Duke University Hospital, Durham, North Carolina

Correspondence: Crystal Heath Dodson, PhD, RN, MSN, BC-ADM, CNE, School of Nursing, University of North Carolina at Wilmington, 601 S College Ave, Wilmington, NC 28403. Tel: 336-552-6490; E-mail:

Competing interests: The authors report no conflicts of interest.

Authors' contributions: C. H. Dodson conducted all analyses and wrote initial draft of the manuscript. E. Baker helped develop semistructure interview guide. K. Bost transcribed interviews.

Received August 21, 2018

Accepted October 11, 2018

© 2019 American Association of Nurse Practitioners
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