Medication Safety Amid Technological Change: Usability Evaluation to Inform Inpatient Nurses' Electronic Health Record System Transition.
J Gen Intern Med
; 38(Suppl 4): 982-990, 2023 10.
Article
em En
| MEDLINE
| ID: mdl-37798581
ABSTRACT
BACKGROUND:
Electronic health record (EHR) system transitions are challenging for healthcare organizations. High-volume, safety-critical tasks like barcode medication administration (BCMA) should be evaluated, yet standards for ensuring safety during transition have not been established.OBJECTIVE:
Identify risks in common and problem-prone medication tasks to inform safe transition between BCMA systems and establish benchmarks for future system changes.DESIGN:
Staff nurses completed simulation-based usability testing in the legacy system (R1) and new system pre- (R2) and post-go-live (R3). Tasks included (1) Hold/Administer, (2) IV Fluids, (3) PRN Pain, (4) Insulin, (5) Downtime/PRN, and (6) Messaging. Audiovisual recordings of task performance were systematically analyzed for time, navigation, and errors. The System Usability Scale measured perceived usability and satisfaction. Post-simulation interviews captured nurses' qualitative comments and perceptions of the systems.PARTICIPANTS:
Fifteen staff nurses completed 2-3-h simulation sessions. Eleven completed both R1 and R2, and seven completed all three rounds. Clinical experience ranged from novice (< 1 year) to experienced (> 10 years). Practice settings included adult and pediatric patient populations in ICU, stepdown, and acute care departments. MAINMEASURES:
Task completion rates/times, safety and non-safety-related use errors (interaction difficulties), and user satisfaction. KEYRESULTS:
Overall success rates remained relatively stable in all tasks except two IV Fluids task success increased substantially (R1 17%, R2 54%, R3 100%) and Downtime/PRN task success decreased (R1 92%, R2 64%, R3 22%). Among the seven nurses who completed all rounds, overall safety-related errors decreased 53% from R1 to R3 and 50% from R2 to R3, and average task times for successfully completed tasks decreased 22% from R1 to R3 and 38% from R2 to R3.CONCLUSIONS:
Usability testing is a reasonable approach to compare different BCMA tasks to anticipate transition problems and establish benchmarks with which to monitor and evaluate system changes going forward.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
1_ASSA2030
Base de dados:
MEDLINE
Assunto principal:
Registros Eletrônicos de Saúde
/
Enfermeiras e Enfermeiros
Tipo de estudo:
Guideline
/
Qualitative_research
Limite:
Adult
/
Child
/
Humans
Idioma:
En
Revista:
J Gen Intern Med
Ano de publicação:
2023
Tipo de documento:
Article