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医院环境中电子处方系统实施、管理、使用及优化的认知与经验:定性研究的系统评价方案

Perceptions and experiences of the implementation, management, use and optimisation of electronic prescribing systems in hospital settings: protocol for a systematic review of qualitative studies.

作者信息

Farre Albert, Bem Danai, Heath Gemma, Shaw Karen, Cummins Carole

机构信息

Institute of Applied Health Research, University of Birmingham, Birmingham, UK Research and Development, Birmingham Children's Hospital NHS Foundation Trust, Birmingham, UK.

Institute of Applied Health Research, University of Birmingham, Birmingham, UK.

出版信息

BMJ Open. 2016 Jul 8;6(7):e011858. doi: 10.1136/bmjopen-2016-011858.

Abstract

INTRODUCTION

There is increasing evidence that electronic prescribing (ePrescribing) or computerised provider/physician order entry (CPOE) systems can improve the quality and safety of healthcare services. However, it has also become clear that their implementation is not straightforward and may create unintended or undesired consequences once in use. In this context, qualitative approaches have been particularly useful and their interpretative synthesis could make an important and timely contribution to the field. This review will aim to identify, appraise and synthesise qualitative studies on ePrescribing/CPOE in hospital settings, with or without clinical decision support.

METHODS AND ANALYSIS

Data sources will include the following bibliographic databases: MEDLINE, MEDLINE In Process, EMBASE, PsycINFO, Social Policy and Practice via Ovid, CINAHL via EBSCO, The Cochrane Library (CDSR, DARE and CENTRAL databases), Nursing and Allied Health Sources, Applied Social Sciences Index and Abstracts via ProQuest and SCOPUS. In addition, other sources will be searched for ongoing studies (ClinicalTrials.gov) and grey literature: Healthcare Management Information Consortium, Conference Proceedings Citation Index (Web of Science) and Sociological abstracts. Studies will be independently screened for eligibility by 2 reviewers. Qualitative studies, either standalone or in the context of mixed-methods designs, reporting the perspectives of any actors involved in the implementation, management and use of ePrescribing/CPOE systems in hospital-based care settings will be included. Data extraction will be conducted by 2 reviewers using a piloted form. Quality appraisal will be based on criteria from the Critical Appraisal Skills Programme checklist and Standards for Reporting Qualitative Research. Studies will not be excluded based on quality assessment. A postsynthesis sensitivity analysis will be undertaken. Data analysis will follow the thematic synthesis method.

ETHICS AND DISSEMINATION

The study does not require ethical approval as primary data will not be collected. The results of the study will be published in a peer-reviewed journal and presented at relevant conferences.

TRIAL REGISTRATION NUMBER

CRD42016035552.

摘要

引言

越来越多的证据表明,电子处方(ePrescribing)或计算机化的医疗服务提供者/医生医嘱录入(CPOE)系统能够提高医疗服务的质量和安全性。然而,同样显而易见的是,这些系统的实施并非一帆风顺,一旦投入使用,可能会产生意想不到或不良的后果。在这种背景下,定性研究方法尤为有用,其解释性综合分析可为该领域做出重要且及时的贡献。本综述旨在识别、评估和综合关于医院环境中电子处方/CPOE(有无临床决策支持)的定性研究。

方法与分析

数据来源将包括以下书目数据库:MEDLINE、MEDLINE 待发表文献、EMBASE、PsycINFO、通过 Ovid 检索的社会政策与实践数据库、通过 EBSCO 检索的护理学与健康相关学科数据库、Cochrane 图书馆(CDSR、DARE 和 CENTRAL 数据库)、护理与联合健康资源库、通过 ProQuest 检索的应用社会科学索引与摘要数据库以及 SCOPUS。此外,还将搜索其他来源以获取正在进行的研究(ClinicalTrials.gov)和灰色文献:医疗保健管理信息联盟、会议论文引用索引(Web of Science)和社会学摘要数据库。研究将由两名评审员独立筛选是否符合纳入标准。将纳入定性研究,无论是单独的定性研究还是混合方法设计中的定性部分,这些研究报告了在医院护理环境中参与电子处方/CPOE 系统实施、管理和使用的任何行为者的观点。数据提取将由两名评审员使用预先测试过的表格进行。质量评估将基于批判性评估技能计划清单和定性研究报告标准的标准。研究不会因质量评估而被排除。将进行综合后敏感性分析。数据分析将遵循主题综合方法。

伦理与传播

本研究无需伦理批准,因为不会收集原始数据。研究结果将发表在同行评审期刊上,并在相关会议上展示。

试验注册号

CRD42016035552。

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