Awareness and Usage of Clinical Decision Support Systems (CDSS) in Antimicrobial Prescribing: A Cross-Sectional Study in Four Tertiary Hospitals and a Nursing School

Abstract

Background: Clinical Decision Support Systems (CDSS) play a vital role in optimizing antimicrobial prescribing, reducing errors, and supporting antimicrobial stewardship (AMS). Limited data exist on the awareness and usage of CDSS among healthcare trainees and paramedical staff in India.

Objectives: To assess the awareness, usage patterns, perceived usefulness, and perceived barriers related to CDSS in antimicrobial prescribing among MBBS students, nursing students, BDS students, and paramedical staff across four tertiary care hospitals and a nursing school.

Methods: A descriptive cross-sectional study was conducted among 100 MBBS students, 100 nursing students, 50 BDS students, and 100 paramedical staff (including nurses and technicians). A validated, self-administered questionnaire assessing awareness, usage frequency, perceived benefits, and barriers was used. Descriptive and comparative statistics were applied.

Results: Awareness of CDSS was highest among MBBS students (78%), followed by BDS students (62%), nursing students (55%), and paramedical staff (38%). Regular usage of CDSS in antimicrobial prescribing was reported by only 21% of participants overall, with MBBS students being the most frequent users (29%). Major perceived benefits included improved prescribing accuracy (72%) and reduced antimicrobial resistance (65%). Key barriers included lack of training (68%), limited system access (54%), and poor integration into workflow (49%).

Conclusion: Despite moderate awareness, CDSS usage remains low across all groups. Enhanced training, improved accessibility, and institutional integration are strongly recommended to promote CDSS adoption and strengthen antimicrobial stewardship.