NURS 6051 Assignment: Use of Clinical Systems to Improve Outcomes

Sample Answer for NURS 6051 Assignment: Use of Clinical Systems to Improve Outcomes Included After Question

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 4 peer-reviewed research articles from your research.
NURS 6051 Assignment: Use of Clinical Systems to Improve Outcomes
For information about annotated bibliographies, visit https://academicguides.waldenu.edu/writingcenter/assignments/annotatedbibliographies

The Assignment: (4-5 pages not including the title and reference page)

In a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. Format your Assignment as an Annotated Bibliography. Be sure to address the following:

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Identify the 4 peer-reviewed research articles you reviewed, citing each in APA format.
Include an introduction explaining the purpose of the paper.
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 your conclusion, synthesize the findings from the 4 peer-reviewed research articles.
Use APA format and include a title page.
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A Sample Answer For the Assignment: NURS 6051 Assignment: Use of Clinical Systems to Improve Outcomes

Title: NURS 6051 Assignment: Use of Clinical Systems to Improve Outcomes

One of the primary focuses of patient care is to offer safe, efficient, and reliable patient care. The implication is that the healthcare sector has in recent times seen a rise in various innovative and inventive approaches toward achieving this aim. Among such approaches is the use of clinical systems, which are almost always technology-based. Clinical systems have widely been used in healthcare to improve care outcomes and efficiencies (Krick et al., 2019). These clinical systems have stemmed from intense research, which is then translated into evidence-based practice. One of such clinical systems is the use of Computerized Provider Order Entry to prevent or minimize medication errors. The purpose of this paper is to present an annotated bibliography on the use of Computerized Provider Order Entry to prevent or minimize medication errors.

Annotated Bibliography

Srinivasamurthy, S. K., Ashokkumar, R., Kodidela, S., Howard, S. C., Samer, C. F., & Rao, U. S. C. (2021). Impact of computerized physician order entry (CPOE) on the incidence of chemotherapy-related medication errors: a systematic review. European Journal of Clinical Pharmacology, 1-9. https://doi.org/10.1007/s00228-021-03099-9

This systematic review authored by Srinivasamurthy et al. (2021) sought to systematically review research outputs evaluating the impacts of the use of Computerized Provider Order Entry on the incidences of chemotherapy-specific medication errors. With a search on four databases for a period covering twenty-five years, these researchers identified a total of 1621 research articles which were reduced to thirty articles upon applying their inclusion criteria (Srinivasamurthy et al., 2021). A meta-analysis using the random-effects model displayed a ninety-five percent confidence level and also favored Computerized Provider Order Entry. Therefore, the reviewed studies showed consistency in lowering the cases of medication errors specific to chemotherapy upon the implementation of Computerized Provider Order Entry, with a reduction of up to 81% revealed from the meta-analysis (Srinivasamurthy et al., 2021). The implication is that the use of Computerized Provider Order Entry has the potential of high efficacy in reducing medication errors related to chemotherapy as long as acclimatization and training offered are accomplished through a multidisciplinary approach.

Chung, C., Patel, S., Lee, R., Fu, L., Reilly, S., Ho, T., … & Taylor, P. (2018). Implementation of an integrated computerized prescriber order-entry system for chemotherapy in a multisite safety-net health system. The Bulletin of the American Society of Hospital Pharmacists, 75(6), 398-406. https://doi.org/10.2146/ajhp170251

Authored by Chung et al. (2018), this article aimed at developing a computerized prescriber order-entry system and possible hurdles that may inhibit a successful implementation. The research sought to find out the efficacy of the computerized prescriber order-entry system as compared to the medication dosage-specific printed order sets for chemotherapy (Chung et al., 2018). The study was done across three facilities where the development of the printed orders sets was often inconsistent due to lack of communication and clinical knowledge disparities. Upon evaluation of the use of the computerized prescriber order entry, the researchers noted a significant drop in cases of medications as a reduction by 75% was noted. In addition, there were site variations in the computerized prescriber order-entry satisfaction, which did not experience any changes in six months post the implementation of computerized prescriber order entry.

The study also revealed some various lessons regarding the applicability of computerized prescriber order-entry including, committing to ongoing support and training of staff, protocols consolidation, the need of computerized prescriber order-entry verification tools, bringing on board Interprofessional stakeholders, and optimizing workflow prior to implementing computerized prescriber order-entry (Chung et al., 2018).

Lichtner, V., Baysari, M., Gates, P., Dalla‐Pozza, L., & Westbrook, J. I. (2019). Medication safety incidents in pediatric oncology after electronic medication management system implementation. European journal of cancer care, 28(6), e13152. https://doi.org/10.1111/ecc.13152.

Lichtner et al. (2019) also explored another study on the use of computerized prescriber order entry. These researchers aimed to explore the medication error connected to computerized prescriber order-entry in pediatric oncology settings. They achieved their aim by analyzing patient safety incident reports. This study analyzed eight hundred and twenty-seven incidences connected to oncology care, and the incidences must have occurred after implementing the computerized prescriber order-entry as an intervention (Lichtner et al., 2019). The findings of the study revealed interesting trends. For example, approximately eighty percent of the incidences were found to be medication-related, with close to forty-five percent of the medication-related incidences connected to the use of computerized prescriber order entry.

Some of the medication-related incidences evaluated include missing chemotherapy, patient transfers, administration, dispensing, and prescribing, among others. Besides, the researchers classified the computerized prescriber order-entry connected events as missing safety features, the unpredicted computerized prescriber order-entry workflow, user experience issues, and technical issues (Lichtner et al., 2019). The analysis of the incidences revealed that the complications that come with interdependencies-therapy rich management were reflected in the incidents with the automation of computerized prescriber order-entry, which contributed to the incidents. The implication is that the use of computerized prescriber order-entry affects safety in various care settings; therefore, those who use the system need to have adept knowledge regarding the behavior of the system and know how to troubleshoot any complication.

Gregory, L. R., Lim, R., MacCullagh, L., Riley, T., Tuqiri, K., Heiler, J., & Peters, K. (2021). Intensive care nurses’ experiences with the new electronic medication administration record. Nursing Open. https://doi.org/10.1002/nop2.939.

This study focused on getting the views and experiences of the intensive care nurses regarding the use of a new computerized prescriber order-entry for managing medication administration. The study was specific to registered nurses who use computerized prescriber order-entry as part of medication administration (Gregory et al., 2021). This study employed a qualitative descriptive exploratory approach study design. The analysis of the results revealed three distinct themes. Such themes include taking time away from the patients, patient safety, and insisting that the nurses operated outside the legally allowed boundaries. It was evidence that nurses were utilizing the workaround practices in intensive care settings when using the computerized prescriber order-entry. Such multiple workarounds have been shown to lead to various medication errors, which negatively impact patient safety. In some cases, the nurses perform workarounds that need them to sign some medications which they did not give to patients or sometimes give out medications to patients without a valid order. Such engagements lead may result in legal and professional consequences.

The study, therefore, revealed that even though the use of computerized prescriber order entry is beneficial, various issues with the technology still exist that could compromise medication administration best practices. Hence, it is vital for nurses to be knowledgeable on some workarounds for safe medication administration. The study also revealed that the nurses were concerned with decreased time directed towards patients as caused by increased screen time (Gregory et al., 2021. The implication is that various considerations should be explored before implementing the system for use in a caring environment. Central to such is patient safety optimization and ensuring that the nurses receive enough support to operate within the legal and professional frameworks.

Conclusion

In conclusion, the application of clinical systems has been on the rise in recent times, largely thanks to the advances in technology and technological applications. One of such systems that have been in use in the healthcare sector for some time now is computerized prescriber order entry. These systems have been connected to various improvements in the clinical care settings regarding the reduction of medication errors that expose patient health to risk. From the four peer-reviewed articles, the use of computerized prescriber order-entry was connected to substantial improvements. For instance, while Srinivasamurthy et al. (2021) study revealed a reduction of up to 81% upon the use of various computerized prescriber order-entry in the clinical setting, through a meta-analysis, Chung et al. (2018) did a study that associated a significant drop of medication errors by 75% upon the use of computer prescriber order entry. In addition, Lichtner et al. (2019) classified the computerized prescriber order-entry connected events as missing safety features, the unpredicted computerized prescriber order-entry workflow, user experience issues, and technical issues. Therefore, for better results, such issues have to be resolved. The view was supported by Gregory et al. (2021), who, through the eyes of nurses, identified some problems that have to be overcome for better outcomes in the use of the systems.

References

Krick, T., Huter, K., Domhoff, D., Schmidt, A., Rothgang, H., & Wolf-Ostermann, K. (2019). Digital technology and nursing care: a scoping review on acceptance, effectiveness and efficiency studies of informal and formal care technologies. BMC health services research, 19(1), 1-15.

Lichtner, V., Baysari, M., Gates, P., Dalla‐Pozza, L., & Westbrook, J. I. (2019). Medication safety incidents in pediatric oncology after electronic medication management system implementation. European journal of cancer care, 28(6), e13152. https://doi.org/10.1111/ecc.13152.