电子医嘱录入和条码给药系统可用性的定量评估方法的系统评价
A Systematic Review of Quantitative Methods for Evaluating Electronic Medication Administration Record and Bar-Coded Medication Administration Usability.
机构信息
National Center for Human Factors in Healthcare, MedStar Health Research Institute, Washington, District of Columbia, United States.
Department of Emergency Medicine, Georgetown University School of Medicine, Washington, District of Columbia, United States.
出版信息
Appl Clin Inform. 2023 Jan;14(1):185-198. doi: 10.1055/s-0043-1761435. Epub 2023 Mar 8.
BACKGROUND
Although electronic medication administration records (eMARs) and bar-coded medication administration (BCMA) have improved medication safety, poor usability of these technologies can increase patient safety risks.
OBJECTIVES
The objective of our systematic review was to identify the impact of eMAR and BCMA design on usability, operationalized as efficiency, effectiveness, and satisfaction.
METHODS
We retrieved peer-reviewed journal articles on BCMA and eMAR quantitative usability measures from PsycInfo and MEDLINE (1946-August 20, 2019), and EMBASE (1976-October 23, 2019). Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we screened articles, extracted and categorized data into the usability categories of effectiveness, efficiency, and satisfaction, and evaluated article quality.
RESULTS
We identified 1,922 articles and extracted data from 41 articles. Twenty-four articles (58.5%) investigated BCMA only, 10 (24.4%) eMAR only, and seven (17.1%) both BCMA and eMAR. Twenty-four articles (58.5%) measured effectiveness, 8 (19.5%) efficiency, and 17 (41.5%) satisfaction. Study designs included randomized controlled trial ( = 1; 2.4%), interrupted time series ( = 1; 2.4%), pretest/posttest ( = 21; 51.2%), posttest only ( = 14; 34.1%), and pretest/posttest and posttest only for different dependent variables ( = 4; 9.8%). Data collection occurred through observations ( = 19, 46.3%), surveys ( = 17, 41.5%), patient safety event reports ( = 9, 22.0%), surveillance ( = 6, 14.6%), and audits ( = 3, 7.3%).
CONCLUSION
Of the 100 measures across the 41 articles, implementing BCMA and/or eMAR broadly resulted in an increase in measures of effectiveness ( = 23, 52.3%) and satisfaction ( = 28, 62.2%) compared to measures of efficiency ( = 3, 27.3%). Future research should focus on eMAR efficiency measures, utilize rigorous study designs, and generate specific design requirements.
背景
尽管电子医嘱系统 (eMAR) 和条码药物管理 (BCMA) 提高了药物安全性，但这些技术的可用性较差会增加患者的安全风险。
目的
本系统评价的目的是确定 eMAR 和 BCMA 设计对可用性的影响，将可用性操作化为效率、效果和满意度。
方法
我们从 PsycInfo 和 MEDLINE（1946 年 8 月 20 日至 2019 年 8 月 20 日）以及 EMBASE（1976 年 10 月 23 日至 2019 年 10 月 23 日）检索了关于 BCMA 和 eMAR 定量可用性措施的同行评议期刊文章。根据系统评价和荟萃分析的首选报告项目 (PRISMA) 指南，我们筛选了文章，提取并将数据分类为效果、效率和满意度的可用性类别，并评估了文章的质量。
结果
我们确定了 1922 篇文章，并从 41 篇文章中提取了数据。24 篇文章（58.5%）仅调查了 BCMA，10 篇（24.4%）仅调查了 eMAR，7 篇（17.1%）同时调查了 BCMA 和 eMAR。24 篇文章（58.5%）测量了效果，8 篇（19.5%）测量了效率，17 篇（41.5%）测量了满意度。研究设计包括随机对照试验（ = 1；2.4%）、中断时间序列（ = 1；2.4%）、前后测试（ = 21；51.2%）、仅后测试（ = 14；34.1%）以及不同因变量的前后测试和后测试（ = 4；9.8%）。数据收集通过观察（ = 19，46.3%）、调查（ = 17，41.5%）、患者安全事件报告（ = 9，22.0%）、监测（ = 6，14.6%）和审计（ = 3，7.3%）进行。
结论
在 41 篇文章的 100 项措施中，与效率措施（ = 3，27.3%）相比，广泛实施 BCMA 和/或 eMAR 通常会增加效果措施（ = 23，52.3%）和满意度措施（ = 28，62.2%）。未来的研究应专注于 eMAR 效率措施，利用严格的研究设计，并生成具体的设计要求。
Zotero 插件