“Rage Against the Machine?”: The Impact of Clinical Decision Support Systems on Hospital Nursing Decision-Making, Workflow Efficiency, and Patient Outcomes: A Rapid Review

Authors

Matthijs Berkhout
HU University of Applied Sciences Utrecht
https://orcid.org/0000-0003-3708-3658
Astrid van Barneveld
Princess Máxima Center for Pediatric Oncology
Koen Smit
HU University of Applied Sciences Utrecht
https://orcid.org/0000-0002-1161-7941
Thijs van Houwelingen
HU University of Applied Sciences Utrecht
https://orcid.org/0000-0002-6173-2454

Synopsis

Clinical Decision Support Systems (CDSS) are increasingly developed for hospital nursing practice, yet their impact on decision-making, workflow efficiency, and patient outcomes remains complex. This rapid review synthesizes findings from 21 studies, highlighting both the benefits and challenges of CDSS implementation focused on three key areas. CDSS can enhance nursing decision-making by reducing variability and improving standardization, but there are concerns about system usability and the tendency to override recommendations. While CDSS improve workflow efficiency by prioritizing tasks, issues such as alert fatigue and poor interoperability with hospital systems hinder their potential. Patient outcomes benefit from CDSS-driven medication safety and risk prevention, yet adherence to recommendations varies among nurses. These findings underscore the need for user-centered CDSS that align with nursing values. Future research should explore long-term effectiveness, implementation strategies and best practices for integrating CDSS into nursing workflows.

Author Biographies

Matthijs Berkhout, HU University of Applied Sciences Utrecht

Utrecht, the Netherlands. E-mail: Matthijs.berkhout@hu.nl 

Astrid van Barneveld, Princess Máxima Center for Pediatric Oncology

Utrecht, the Netherlands. E-mail: a.vanbarneveld@prinsesmaximacentrum.nl

Koen Smit, HU University of Applied Sciences Utrecht

Utrecht, the Netherlands. E-mail: Koen.smit@hu.nl

Thijs van Houwelingen, HU University of Applied Sciences Utrecht

Utrecht, the Netherlands. E-mail: thijs.vanhouwelingen@hu.nl

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Published

June 9, 2025

License

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

How to Cite

Matthijs Berkhout, M. B., van Barneveld, A. ., Smit, K., & van Houwelingen, T. (2025). “Rage Against the Machine?”: The Impact of Clinical Decision Support Systems on Hospital Nursing Decision-Making, Workflow Efficiency, and Patient Outcomes: A Rapid Review. In A. Pucihar, M. Kljajić Borštnar, S. Blatnik, M. Marolt, R. W. H. Bons, K. Smit, & M. Glowatz (Eds.), & (Ed.), 38th Bled eConference: Empowering Transformation: Shaping Digital Futures for All: Conference Proceedings (pp. 351-366). University of Maribor Press. https://press.um.si/index.php/ump/catalog/book/947/chapter/607