Evidence map›Paper›PMID 37798581›Full record

ArticleJournal of general internal medicine2023

Medication Safety Amid Technological Change: Usability Evaluation to Inform Inpatient Nurses' Electronic Health Record System Transition.

Carrie Reale, Deborah A Ariosto, Matthew B Weinger, Shilo Anders

Abstract read
In one paragraph

Article in Journal of general internal medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Carrie RealeCenter for Research and Innovation in Systems Safety, Department of Anesthesiology, Institute for Medicine and Public Health, and the Center for Health Services Research, Vanderbilt University Medical Center, Nashville, TN, USA. carrie.reale@vumc.org.ORCID 0000-0002-9011-2692
Deborah A AriostoDepartment of Patient Care Services, Vanderbilt University Medical Center, Nashville, USA.
Matthew B WeingerCenter for Research and Innovation in Systems Safety, Department of Anesthesiology, Institute for Medicine and Public Health, and the Center for Health Services Research, Vanderbilt University Medical Center, Nashville, TN, USA.
Shilo AndersCenter for Research and Innovation in Systems Safety, Department of Anesthesiology, Institute for Medicine and Public Health, and the Center for Health Services Research, Vanderbilt University Medical Center, Nashville, TN, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundElectronic health record (EHR) system transitions are challenging for healthcare organizations. High-volume, safety-critical tasks like barcode medication administration (BCMA) should be evaluated, yet standards for ensuring safety during transition have not been established.

objectiveIdentify risks in common and problem-prone medication tasks to inform safe transition between BCMA systems and establish benchmarks for future system changes.

designStaff nurses completed simulation-based usability testing in the legacy system (R1) and new system pre- (R2) and post-go-live (R3). Tasks included (1) Hold/Administer, (2) IV Fluids, (3) PRN Pain, (4) Insulin, (5) Downtime/PRN, and (6) Messaging. Audiovisual recordings of task performance were systematically analyzed for time, navigation, and errors. The System Usability Scale measured perceived usability and satisfaction. Post-simulation interviews captured nurses' qualitative comments and perceptions of the systems.

participantsFifteen staff nurses completed 2-3-h simulation sessions. Eleven completed both R1 and R2, and seven completed all three rounds. Clinical experience ranged from novice (< 1 year) to experienced (> 10 years). Practice settings included adult and pediatric patient populations in ICU, stepdown, and acute care departments. MAIN MEASURES: Task completion rates/times, safety and non-safety-related use errors (interaction difficulties), and user satisfaction. KEY

resultsOverall success rates remained relatively stable in all tasks except two: IV Fluids task success increased substantially (R1: 17%, R2: 54%, R3: 100%) and Downtime/PRN task success decreased (R1: 92%, R2: 64%, R3: 22%). Among the seven nurses who completed all rounds, overall safety-related errors decreased 53% from R1 to R3 and 50% from R2 to R3, and average task times for successfully completed tasks decreased 22% from R1 to R3 and 38% from R2 to R3.

conclusionsUsability testing is a reasonable approach to compare different BCMA tasks to anticipate transition problems and establish benchmarks with which to monitor and evaluate system changes going forward.

Indexed as

Electronic Health RecordsNursesAdultChildComputer SimulationHumansInpatientsbarcode medication administrationEHR transitionpatient safetyusability evaluation

Identifiers

PMID37798581
PMCPMC10593701

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.