Bakken Suzanne
Columbia University School of Nursing, New York, New York, USA.
Annu Rev Nurs Res. 2006;24:219-54.
In Crossing the Quality Chasm, the Institute of Medicine (IOM) Committee on Quality of Health Care in America identified the critical role of information technology in designing a health system that produces care that is "safe, effective, patient-centered, timely, efficient, and equitable" (Committee on Quality of Health Care in America, 2001, p. 164). A subsequent IOM report contends that improved information systems are essential to a new health care delivery system that "both prevents errors and learns from them when they occur" (Committee on Data Standards for Patient Safety, 2004, p. 1). This review specifically highlights the role of informatics processes and information technology in promoting patient safety and summarizes relevant nursing research. First, the components of an informatics infrastructure for patient safety are described within the context of the national framework for delivering consumer-centric and information-rich health care and using the National Health Information Infrastructure (NHII) (Thompson & Brailer, 2004). Second, relevant nursing research is summarized; this includes research studies that contributed to the development of selected infrastructure components as well as studies specifically focused on patient safety. Third, knowledge gaps and opportunities for nursing research are identified for each main topic. The health information technologies deployed as part of the national framework must support nursing practice in a manner that enables prevention of medical errors and promotion of patient safety and contributes to the development of practice-based nursing knowledge as well as best practices for patient safety. The seminal work that has been completed to date is necessary, but not sufficient, to achieve this objective.
在《跨越质量鸿沟》中,美国医学研究所(IOM)医疗保健质量委员会确定了信息技术在设计一个能提供“安全、有效、以患者为中心、及时、高效和公平”护理的卫生系统中的关键作用(美国医疗保健质量委员会,2001年,第164页)。IOM随后的一份报告认为,改进信息系统对于一个“既能预防错误又能在错误发生时从中吸取教训”的新医疗保健提供系统至关重要(患者安全数据标准委员会,2004年,第1页)。本综述特别强调了信息学流程和信息技术在促进患者安全方面的作用,并总结了相关的护理研究。首先,在以消费者为中心且信息丰富的医疗保健提供的国家框架背景下,并利用国家卫生信息基础设施(NHII)(汤普森和布赖勒,2004年),描述了用于患者安全的信息学基础设施的组成部分。其次,总结了相关的护理研究;这包括有助于选定基础设施组成部分发展的研究以及专门关注患者安全的研究。第三,针对每个主要主题确定了护理研究的知识差距和机会。作为国家框架一部分部署的卫生信息技术必须以一种能够预防医疗错误、促进患者安全并有助于基于实践的护理知识发展以及患者安全最佳实践的方式来支持护理实践。迄今为止已经完成的开创性工作对于实现这一目标是必要的,但还不够。