Nursing informatics and patient safety outcomes in critical care settings: a systematic review.

AIM

Conduct a systematic review to analyse how nursing informatics influence patient safety outcomes in critical care settings.

RESEARCH METHODOLOGY/DESIGN: The following database searches were conducted: Ovid MEDLINE, Cochrane library, Cochrane CENTRAL, CINAHL plus, Ovid Emcare, PsycINFO, and Ovid Embase. Two reviewers conducted the data selection and critical appraisal independently, following the JBI evaluation guidelines. Seventeen articles of high quality were included in this review.

SETTINGS

This systematic review focused on critical care settings in healthcare facilities, including Emergency Departments, Intensive Care Units, High Dependency Units and Coronary Care Units in public or private hospitals.

MAIN OUTCOME MEASURES

The overarching outcomes evaluated were patient safety outcomes (e, g, the development of a pressure injury), patient safety outcome measures (i.e., the application of tools used to measure patient safety outcomes e.g. the frequency with which pressure areas are assessed) and the processes of care (e.g. conducting regular pressure area care to prevent pressure injuries).

RESULTS

In critical care settings, nursing informatics were associated with promotion of patient safety and prevention of adverse incidents, including reducing the incidence of pressure ulcers and medication errors; helping control blood glucose levels; decreasing the length of hospital stay; and improving compliance with care bundles and overall screening completion rates for risks of pressure ulcers, falls, substance use and agitation in emergency departments.

CONCLUSION

The implementation of nursing informatics in critical care areas has been successful in promoting patient safety. While informatics can be costly to introduce, there is evidence these interventions can reduce costs by preventing adverse events.

IMPLICATIONS FOR CRITICAL PRACTICE

Electronic health information record systems, clinical decision support systems and telehealth can increase compliance with screening and delivery of care aligned with guidelines across a range of presentations and critical care contexts. With the growing prevalence of nursing informatics, these systems should be considered for more widespread introduction.