Background. Nursing homes face challenges in the coming years due to the increased number of elderly. Quality will be under\npressure, expectations of the services will rise, and clinical complexity will grow. New strategies are needed to meet this situation.\nModern clinical information systems with decision support may be part of that. Objectives. To study the impact of introducing an\nelectronic patient record system with decision support on the use of warfarin, neuroleptics and weighing of patients, in nursing\nhomes. Methods. A prevalence study was performed in seven nursing homes with 513 subjects. A before-after study with internal\ncontrols was performed. Results. The prevalence of atrial fibrillation in the seven nursing homes was 18.8%. After intervention, the\nproportion of all patients taking warfarin increased from 3.0% to 9.8% (P = 0.0086), neuroleptics decreased from 33.0% to 21.5%\n(P = 0.0121), and the proportion not weighed decreased from 72.6% to 16.0% (P < 0.0001). The internal controls did not change\nsignificantly. Conclusion. Statistics and management data can be continuously produced to monitor the quality of work processes.\nThe electronic health record system and its system for decision support can improve drug therapy and monitoring of treatment\npolicy.
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