Sini Kuitunen, Bruna L Alves, Hanna Peitsoma, Muhammad Z Saleem, Lotta Schepel, Anna-Riia Holmström
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引用次数: 0
Abstract
Objectives: To explore the effects of bidirectional interoperability between electronic health records (EHR) and smart infusion pumps on medication errors (MEs), system compliance and workflow efficiency and economic aspects.
Methods: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 criteria. The literature search on Scopus, MEDLINE (Ovid), Web of Science, Cumulated Index in Nursing and Allied Health Literature, and Evidence-Based Medicine Reviews was conducted on 3 October 2024. Peer-reviewed studies considering bidirectional interoperability between EHR and smart pumps in hospitals were included. Study selection according to a predetermined Population, Intervention, Comparison(s) and Outcome tool, data extraction and evidence quality assessment (Joanna Briggs Institute critical appraisal tool assessment and the Grading of Recommendations Assessment, Development and Evaluation approach) were carried out by two individual reviewers.
Results: Seven studies from the USA, published between 2011 and 2024, were included. The studies used variable designs to compare the effects of bidirectional interoperability between smart infusion pumps and EHR on system compliance and workflow efficiency (n=6 studies), MEs (n=3) and economic outcomes (n=2) before and after implementation. The observed effects were mainly positive; however, evidence quality was low because of the observational nature of studies.
Discussion: The interoperability between EHR systems and smart infusion pumps remains a relatively novel research topic. Evidence is geographically concentrated, limiting its generalisability to different healthcare systems, regulatory environments and technology adoption patterns.
Conclusion: While bidirectional interoperability may reduce MEs, improve system compliance and workflow efficiency and enhance hospitals' charging accuracy of provided care, future studies should prioritise controlled designs, robust data and economic outcomes to justify the investment.
目的：探讨电子健康档案（EHR）与智能输液泵双向互操作对用药差错（MEs）、系统合规性、工作流程效率和经济方面的影响。方法：本系统评价遵循系统评价和元分析2020标准的首选报告项目。于2024年10月3日在Scopus、MEDLINE （Ovid）、Web of Science、护理及相关健康文献累积索引和循证医学评论等平台进行文献检索。同行评议的研究考虑了医院中电子病历和智能泵之间的双向互操作性。根据预先确定的人群、干预、比较和结果工具、数据提取和证据质量评估（乔安娜布里格斯研究所关键评估工具评估和建议分级评估、发展和评估方法）进行研究选择。结果：纳入了2011年至2024年间发表的7项美国研究。这些研究采用变量设计来比较智能输液泵和电子病历双向互操作性在实施前后对系统依从性和工作流程效率（n=6项研究）、MEs （n=3）和经济结果（n=2）的影响。观察到的效应以正效应为主；然而，由于研究的观察性，证据质量较低。讨论：电子病历系统和智能输液泵之间的互操作性仍然是一个相对较新的研究课题。证据在地理上集中，限制了其在不同医疗保健系统、监管环境和技术采用模式中的普遍性。结论：虽然双向互操作性可以减少MEs，提高系统合规性和工作流程效率，并提高医院对所提供护理的收费准确性，但未来的研究应优先考虑受控设计，稳健的数据和经济结果，以证明投资的合理性。普洛斯彼罗注册号：CRD42024538518。
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