LITERATURE REVIEW: THE USE OF CLINICAL SYSTEMS TO IMPROVE OUTCOMES AND EFFICIENCIES

Literature review: The use of clinical systems to improve outcomes and efficiencies

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:

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.
Use the Safe Assign Drafts to check your Literature review: The use of clinical systems to improve outcomes and efficiencies match percentage before submitting your work.

The Impact of Computerized Point Order Entry in Enhancing Efficiency and Patient Outcomes

Healthcare organizations are highly investing in the adoption and implementation of clinical systems. Such systems include electronic health records, electronic medical records, computerized point order entry (CPOE), and clinical decision support systems. The adoption and implementation of clinical systems significantly improve clinical workflow, efficiency, and patient outcomes. The utilization of CPOE has been established as a valuable system for enhancing workflow, efficiency, and patient outcome. The system allows providers to enter and send treatment instructions, including lab tests and medications. The system’s efficacy has been identified in reducing medical errors, turnaround time, automation calculation of doses, and remote access to prescription orders Literature review: The use of clinical systems to improve outcomes and efficiencies. This paper aims to evaluate the impact of CPOE in reducing medication errors and enhancing patient safety.

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Annotated Bibliography

Srinivasamurthy, S. K., Ashokkumar, R., Kodidela, S., Howard, S. C., Samer, C. F., & Chakradhara Rao, U. S. (2021). Impact of computerized physician Order Entry (CPOE) on the incidence of chemotherapy-related medication errors: A systematic review. European Journal of Clinical Pharmacology, 77(8), 1123–1131. https://doi.org/10.1007/s00228-021-03099-9

The study evaluated the impacts of computerized point order entry in reducing chemotherapy-related medication errors. A systematic review was conducted on different databases, including Medline, Web of Science, Agency for Healthcare Research and Quality, and Cumulative Index to Nursing and Allied Health Literature databases between 1995 to 2019. The inclusion criteria were English articles evaluating the impact of CPOE on chemotherapy medication error Literature review: The use of clinical systems to improve outcomes and efficiencies. A total of 1621 papers were identified, and after thorough screening and categorization, only 15 articles were used for the systematic review. The study results showed that CPOE significantly reduced chemotherapy-related medication errors by approximately 94%, specifically by reducing dosing calculation errors. In another article, the authors identified that CPOE reduced prescription errors by 69% within six months of its implementation.

The authors established that implementing CPOE significantly reduced the error to 81%, thus a valuable tool in medical error reduction. In addition, the system reduced errors by 76% in hospitalized patients and 85% among patients in the intensive care unit. The study highlights that despite the system’s value, frequent monitoring and training are fundamental during the implementation phase. In addition, the system may require a link between computerized treatment protocols and drug protocols to ensure the chances of medical errors are reduced to zero. From the review, a lesson learned is that CPOEs effectively improve satisfaction and accurate documentation in the outpatient oncological setting.

Amiri, P., Rahimi, B., & Khalkhali, H. R. (2020). Nurses’ attitudes toward Computerized Provider Order Entry (CPOE) system: A feasibility study before implementation. Journal of Clinical Research in Paramedical Sciences, 9(2). https://doi.org/10.5812/jcrps.101420

The authors conducted a study to gain insight into nurses’ attitudes toward implementing and adopting CPOE. The methodology utilized was a cross-sectional study in four hospitals. The nurses working in the hospitals were used for the analysis. A multi-section questionnaire was used to collect information on nurses’ attitudes toward CPOE literacy, level of CPOE literacy, and nurse demographics. The study result showed that nurses associated CPOE with easier documentation management compared with paper records, thus significantly saving on turnaround time Literature review: The use of clinical systems to improve outcomes and efficiencies.

The study finding showed the efficacy of CPOE in providing just-in-time feedback to physicians, thus significantly reducing turnaround time in drug prescription. In addition, the study results showed that CPOE reduces medication errors as physicians can identify and correct errors during drug prescriptions. Reduction of medical errors is positively associated with increased patient satisfaction. The article also highlights the efficacy of CPOE in enhancing prescription legibility. Lastly, other benefits of CPOE identified in the study include order legibility, response time, a decline in adverse drug reactions, and improved patient outcomes.

Keenan, R., Kushniruk, A. W., & Borycki, E. M. (2021). Computerized provider order entry and patient safety: A scoping review. Knowledge Management & E-Learning: An International Journal, 452–476. https://doi.org/10.34105/j.kmel.2021.13.025

The study aimed to establish the potential patient safety benefits of implementing computerized point order entry. The authors conducted a systematic review of articles that identify and describe the effects of CPOE on patient safety. The Arksey and O’Malley framework was utilized to perform the systematic review. A search was conducted on different databases, including Medline, CINAHL, Web of Science, and IEEE Xplore. The key terms used were CPOE and benefits to patient safety. The inclusion criteria were English-only databases that were between 2010 to 2020 Literature review: The use of clinical systems to improve outcomes and efficiencies. A total of 237 studies were identified, and after screening for relevancy, twenty-three articles were used.

The research findings showed the implementation of CPOE was significantly associated with improved patient safety through the reduction of medical errors and a decline in adverse drug events. The authors established with the CPOE capability of flags and alerts enhance patient safety by preventing medication errors and omission which may cause harm to patient health. Reduced significantly. The study provides insight into the need to project potential risks associated with CPOE to implement risk mitigation strategies that will ensure a successful implementation process.

Khammarnia, M., Sharifian, R., Zand, F., Barati, O., Keshtkaran, A., Sabetian, G., Shahrokh, N., & Setoodezadeh, F. (2017). The impact of computerized physician order entry on prescription orders: A quasi-experimental study in Iran. Medical Journal of the Islamic Republic of Iran, 31(1), 396–400. https://doi.org/10.14196/mjiri.31.69

The study was conducted to compare results on prescription orders between two groups before and after CPOE implementation in a hospital. A prospective analysis in 2 intensive care units of a large tertiary public hospital was performed before and after CPOE implementation between the years 2014 to 2016. The central ICU and general ICU were used as control and intervention. CPOEs were placed in the intervention wards. The prescription orders were compared before and after implementation, and SPSS version 21, descriptive statistics, and analytical tests were used for data analysis. The research findings revealed that implementing CPOE significantly reduces two medical prescription errors. Before its performance, 1310 orders were recorded in the general ICU and 920 in the central ICU. In the general ICU, at least 251 orders had an error; in the main unit, 136 had an error. After CPOE implementation, 3045 orders were recorded in the general ICU, with only 92 orders having an error. In the central unit, 1263 orders were recorded, of which 189 had an error.

In summary, the efficacy of CPOE implementation has been established in several studies. The systems have been identified to enhance patient safety by significantly reducing medication and prescription errors. In addition, the systems have improved efficiency by reducing the turnaround time and automating prescription dosing Literature review: The use of clinical systems to improve outcomes and efficiencies. Therefore, organization should invest in adopting and implementing CPOE for easy clinical workflow.

References

Amiri, P., Rahimi, B., & Khalkhali, H. R. (2018). Determinant of successful implementation of Computerized Provider Order Entry (CPOE) system from physicians’ perspective: Feasibility Study prior to implementation. Electronic Physician, 10(1), 6201–6207. https://doi.org/10.19082/6201

Srinivasamurthy, S. K., Ashokkumar, R., Kodidela, S., Howard, S. C., Samer, C. F., & Chakradhara Rao, U. S. (2021). Impact of computerised physician Order Entry (CPOE) on the incidence of chemotherapy-related medication errors: A systematic review. European Journal of Clinical Pharmacology, 77(8), 1123–1131. https://doi.org/10.1007/s00228-021-03099-9 Literature review: The use of clinical systems to improve outcomes and efficiencies