背景:尽管电子用药记录(eMAR)和条形码用药(BCMA)改善了用药安全性,这些技术的可用性差会增加患者的安全风险。
目的:我们系统评价的目的是确定eMAR和BCMA设计对可用性的影响,作为效率来操作,有效性,和满意度。
方法:我们从PsycInfo和MEDLINE(1946-2019年8月20日)检索了有关BCMA和eMAR定量可用性度量的同行评审期刊文章,和EMBASE(1976年-2019年10月23日)。遵循系统审查和荟萃分析(PRISMA)指南的首选报告项目,我们筛选了文章,将数据提取并分类到有效性的可用性类别中,效率,和满意,并评价文章质量。
结果:我们确定了1,922篇文章,并从41篇文章中提取了数据。二十四篇文章(58.5%)只调查了BCMA,仅10(24.4%)eMAR,和七个(17.1%)BCMA和eMAR。二十四篇文章(58.5%)测量有效性,8(19.5%)效率,和17(41.5%)满意度。研究设计包括随机对照试验(n=1;2.4%),中断时间序列(n=1;2.4%),前测/后测(n=21;51.2%),仅后验(n=14;34.1%),前测/后测和后测仅适用于不同的因变量(n=4;9.8%)。通过观测收集数据(n=19,46.3%),调查(n=17,41.5%),患者安全事件报告(n=9,22.0%),监测(n=6,14.6%),和审计(n=3,7.3%)。
结论:在41篇文章的100项措施中,与效率衡量标准(n=3,27.3%)相比,实施BCMA和/或eMAR的有效性衡量标准(n=23,52.3%)和满意度衡量标准(n=28,62.2%)均有所提高.未来的研究应该集中在eMAR效率测度上,利用严格的研究设计,并生成具体的设计要求。
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.
The objective of our systematic review was to identify the impact of eMAR and BCMA design on usability, operationalized as efficiency, effectiveness, and satisfaction.
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.
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 (n = 1; 2.4%), interrupted time series (n = 1; 2.4%), pretest/posttest (n = 21; 51.2%), posttest only (n = 14; 34.1%), and pretest/posttest and posttest only for different dependent variables (n = 4; 9.8%). Data collection occurred through observations (n = 19, 46.3%), surveys (n = 17, 41.5%), patient safety event reports (n = 9, 22.0%), surveillance (n = 6, 14.6%), and audits (n = 3, 7.3%).
Of the 100 measures across the 41 articles, implementing BCMA and/or eMAR broadly resulted in an increase in measures of effectiveness (n = 23, 52.3%) and satisfaction (n = 28, 62.2%) compared to measures of efficiency (n = 3, 27.3%). Future research should focus on eMAR efficiency measures, utilize rigorous study designs, and generate specific design requirements.