Literature Review: The Use of Clinical Systems

Literature Review: The Use of Clinical Systems

Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies

New technology—and the application of existing technology—only appears in healthcare settings after careful and significant research. The stakes are high, and new clinical systems need to offer evidence of positive impact on outcomes or efficiencies.

Nurse informaticists and healthcare leaders formulate clinical system strategies. As these strategies are often based on technology trends, informaticists and others have then benefited from consulting existing research to inform their thinking.

In this Assignment, you will review existing research focused on the application of clinical systems. After reviewing, you will summarize your findings.

To Prepare:

• Review the Resources and reflect on the impact of clinical systems on outcomes and efficiencies within the context of nursing practice and healthcare delivery.
• Conduct a search for recent (within the last 5 years) research focused on the application of clinical systems. The research should provide evidence to support the use of one type of clinical system to improve outcomes and/or efficiencies, such as “the use of personal health records or portals to support patients newly diagnosed with diabetes.”
• Identify and select 5 peer-reviewed articles from your research.

The Assignment: (4-5 pages)

In a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. Be sure to address the following:

• Identify the 5 peer-reviewed articles you reviewed, citing each in APA format.
• Summarize each study, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described. Be specific and provide examples.

In a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. Be sure to address the following:·   Properly identify 5 peer-reviewed articles selected.·   Summarize each study, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described. Be specific and provide examples.

SAMPLE ANSWER

Transforming Nursing and Healthcare through Technology

Introduction

Technology has played an instrumental role in changing healthcare. With an evolving healthcare system, nurses face the challenge of learning new skills and integrating them into practice. From unique interventions like tablet computers to radio frequency identification-enabled devices, the healthcare field is becoming more efficient. Nurses are now using technology to update patient records, schedule care and navigate online systems (Thimbleby, 2014). Long gone are the days when patient information was stored in handwritten charts. Now, patient’s data is safely and efficiently stored in electronic health records thus transforming the nursing profession. In addition, technology has improved communication between medical personnel during emergencies. Technology has made nursing work easier and as a result, increased the number of patients that nurses are likely to attend to. While technology improves communication and work efficiency, there can be several challenges when new technology is implemented. Nurses and other care givers report experiencing difficulties in effectively communicating patient information. Additionally, there is a high privacy risk associated with using technology devices to record patient data (Thimbleby, 2014). The use of technology in healthcare is expected to rise in the future. When it comes to nursing, technology advances will improve the ability of nurses to offer quality, accurate and efficient care to patients.

Use of Health Information Technology for Older Adults Care

In recent years, health information technology (HIT) has been used to improve care for the elderly. With the introduction of the Health Information Technology for Economic and Clinical Health Act, more research is being conducted to analyze the impact of electronic health records (EHR) and health information technology on the quality of care offered to older patients. Dowding and colleagues (2014), analyzed the impact of using EHR to improve outcomes such as the rate of elderly falls and pressure ulcers. The study investigated 29 hospitals and analyzed how their EHR systems affected documentation of patient information. According to the study, EHR systems were associated with improved documentation of pressure ulcers and falls in the hospitals investigated. Additionally, using EHR reduced pressure ulcers rates by 13%. However, the fall rates were not affected by the introduction of EHR systems. The study concluded that for effective change to be established and for successful EHR system to be installed, collaboration, teamwork and supportive leadership must be maintained.

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Impact of Bar-Code Medication Administration (BCMA) on Patient Harm

Medical errors pose serious risks to hospitalized patients. Medication errors are among the most common medical errors in healthcare facilities. These errors are categorized into prescribing errors, transcribing errors, dispensing and administration errors. Historically, several techniques have been developed to reduce administration errors. Barcode verification technology mitigates human errors by automating five key areas-patient, drug, dose, route and time-and alerts nurses to any violation. Thompson et al (2018) sought to evaluate the impact of implementing barcode medication administration technology on the rate of medical errors more specifically medication administration errors that result in patient harm. From March, 2007 to September, 2013 the study analyzed adherence to BCMA technology and tracked the number of actual errors during the study period. According to the results, there was a 43.5% reduction in medical administration errors after BCMA technology was introduced. The rate at which harmful medication errors were administered decreased from 0.65 per 100,000 to 0.29 per 100,000 medications. Overall, the use of BCMA technology significantly reduces medication administration errors.

Literature Review: The Use of Clinical Systems

Intravenous Smart Pumps

With over 90% of hospitalized patients receiving medication intravenously via infusion pumps, intravenous smart pumps are among the most used technologies in hospitals and healthcare facilities. Smart pump technologies have been proven to be profitable in intensive care units as they save costs and prevent medication errors. Rosas and colleagues (2018) evaluated the economic impact of implementing smart infusion pumps in the administration of intravenous drugs and solutions in the intensive care unit (ICU). The retrospective observational study analyzed patterns of consumption of intravenous solutions pre-implementation and post-implementation of smart pumps. The results show that the implemented smart pumps reduced the annual consumption of intravenous solutions by 18% units and by 22.3% liters. Additionally, the study observed that the smart pumps lowered the cost of IV administration by 17.1% when compared to conventional infusion systems. The results therefore prove that smart infusion pumps save costs specifically for the administration of intravenous solutions in the intensive care unit.

Intelligent Healthcare Data Management System (IHDMS)

With the increase in the development of intelligent healthcare systems, come more novel approaches that rely on Nanosensors and smart phone technologies. Patients are now using intelligent healthcare data management systems to access healthcare services including emergency management services and diagnosis services. IHDMS with nanosensors involves the use of wearable nanosensors, individual applications that are executed on smart phones and medical or healthcare servers (Dorj et al. 2017). In recent year, nanosensors have been utilized to solve human problems and treat diseases. Intelligent healthcare data management systems have also been used to maintain medical equipments. Hamdi et al (2014), developed a novel software system and applied it in the maintenance management of medical technologies. The researchers sorted medical maintenance requests and calculated priority indexes for the requests. Additionally, model performance was assessed by analyzing maintenance requests. The results showed significant improvements in equipment downtimes based on healthcare delivery capacity. This ultimately improved patient outcomes. The results conclude that IHDMS improves medical equipment reliability, safety and maintains cost efficiency.

Literature Review: The Use of Clinical Systems

Automated Medication Dispensing Cabinets (AMDC)

Automated medication dispensing cabinets are designed to provide computer-controlled storage, dispensing of medication and tracking at the point of care. AMDC offers several benefits to users and to patients. These cabinets provide nurses with total access to medication; they provide control of medications and greatly reduce medical errors. Moreno et al. (2014), sort to estimate the return on investment of an AMDC taking into account its role on the reduction in drug consumption. The study compared drug consumption rates in two separate wards with similar medicine use characteristics. The two wards used ADC model OmniSupplier and an inventory of the medication used was analyzed. The results showed a significant difference in the total cost of medication consumed by the control ward and the two test wards. The results showed a 16.3% reduction in drug consumption. Additionally, there was a median stock reduction of 56.5%. When the investigators compared the results, they observed a consistent reduction in the consumption of medicines. The study concludes that installation of automated medication dispensing cabinets reduce drug consumption, improve efficiency and save on medication costs.

Literature Review: The Use of Clinical Systems

Conclusion

New technology is changing the way people live their lives. And now more than ever before, technological advancements are impacting the healthcare industry in unique ways. In the healthcare industry, new technologies are used to improve patient care and ensure quality nursing care. Many new medical technologies help nurses with routine processes. For example, automated medication dispensing cabinets help nurses decrease human mistakes, improve efficiency and reduce medication consumption rates. Smart pumps on the other hand, have been used in ICUs to administer IV substances and medications. Electronic health records reduce medical errors and increase the time nurses allocate to each patient. While technology and innovation improve quality of care, all nurses agree that it should not replace day-to-day human interactions.

References

Dorj, U., Lee, M., Choi, J., Lee. Y. & Jeong, G. (2017). The Intelligent Healthcare Data Management System Using Nanosensors. Journal of Sensors, 9. Doi: 10.1155/2017/7483075

Dowding, DW., Turley, M. & Garrido, T. (2014). The Impact of n electronic Health Record on Nurse Sensitive Patient Outcomes: An Interrupted Time Series Analysis. Journal of the American Medical Informatics Association, 19(4), 615-620. Doi: 10.1136/amiajnl-2011-000504.

Hamdi, N., Oweis, R., Zraiq, H. A. & Sammour, D. (2014). An Intelligent Healthcare Management System: A New Approach in Work-Order Prioritization for Medical Equipment Maintenance Requests. Journal of Medical Systems, 36(2), 557-567. Doi: 10.1007/s10916-010-9501-4

Moreno, M.M. et al. (2014). Return on Investment for Automated Dispensing Cabinets. European Journal of Hospital Pharmacy, 19(2). Doi: 10.1136/ejhpharm-2012-000074.3014

Rosas, EP. Et al. (2018). Impact of Implementing Smart Infusion Pumps in an Intensive Care Unit in Mexico: A Pre-Post Cost Analysis Based on Intravenous Solutions Consumption, 54(13): Hospital Pharmacy. Doi: 10.1177/0018578718786943

Thimbleby, H. (2014). Technology and the Future of Healthcare. Journal of Public Health Research, 2(3). Doi: 10.4081/jphr.2013.e28

Thompson, K.M et al. (2018). Implementation of Bar-Code Medication Administration to Reduce Patient Harm. Mayo Clinic Proceedings: Innovations, Quality & Outcomes, 2(4), 342-351. Doi: 10.1016/j.mayocpiqo.2018.09.001

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