Methods for studying medication safety following electronic health record implementation in acute care: a scoping review.

Nichole Pereira, Jonathan P Duff, Tracy Hayward, Tamizan Kherani, Nadine Moniz, Chrystale Champigny, Andrew Carson-Stevens, Paul Bowie, Rylan Egan
Author Information
  1. Nichole Pereira: Faculty of Health Sciences, Health Quality Program, Queen's University, Kingston, ON K7L 3N6, Canada. ORCID
  2. Jonathan P Duff: Pediatric Intensive Care Unit, Alberta Health Services, Edmonton, AB T6G 2B7, Canada.
  3. Tracy Hayward: Department of Patient Safety, Covenant Health, Edmonton, AB T5R 4H5, Canada.
  4. Tamizan Kherani: Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 1C9, Canada.
  5. Nadine Moniz: Stroke Program, Alberta Health Services, Edmonton, AB T6G 2J3, Canada.
  6. Chrystale Champigny: Primary Health Care, Alberta Health Services, Edmonton, AB T6G 2B7, Canada.
  7. Andrew Carson-Stevens: Faculty of Health Sciences, Health Quality Program, Queen's University, Kingston, ON K7L 3N6, Canada.
  8. Paul Bowie: Faculty of Health Sciences, Health Quality Program, Queen's University, Kingston, ON K7L 3N6, Canada.
  9. Rylan Egan: Faculty of Health Sciences, Health Quality Program, Queen's University, Kingston, ON K7L 3N6, Canada.

Abstract

OBJECTIVES: The objective of this scoping review is to map methods used to study medication safety following electronic health record (EHR) implementation. Patterns and methodological gaps can provide insight for future research design.
MATERIALS AND METHODS: We used the Joanna Briggs Institute scoping review methodology and a custom data extraction table to summarize the following data: (1) study demographics (year, country, setting); (2) study design, study period, data sources, and measures; (3) analysis strategy; (4) identified limitations or recommendations; (5) quality appraisal; and (6) if a Safety-I or Safety-II perspective was employed.
RESULTS: We screened 5879 articles. One hundred and fifteen articles met our inclusion criteria and were assessed for eligibility by full-text review. Twenty-seven articles were eligible for extraction.
DISCUSSION AND CONCLUSION: We found little consistency in how medication safety following EHR implementation was studied. Three study designs, 7 study settings, and 10 data sources were used across 27 articles. None of the articles shared the same combination of design, data sources, study periods, and research settings. Outcome measures were neither defined nor measured consistently. It may be difficult for researchers to aggregate and synthesize medication safety findings following EHR implementation research. All studies but one used a Safety-I perspective to study medication safety. We offer a conceptual model to support a more consistent approach to studying medication safety following EHR implementation.

Keywords

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Grants

  1. /Canadian Nurses Foundation
  2. /Canadian Nurses Foundation Dr. Kathryn J Hannah Nursing Informatics

MeSH Term

Humans
Electronic Health Records
Critical Care

Word Cloud

Created with Highcharts 10.0.0studymedicationsafetyfollowingimplementationarticlesreviewusedEHRdatascopingelectronichealthrecordresearchdesignsourcesANDextractionmeasuresSafety-IperspectivesettingsconceptualstudyingOBJECTIVES:objectivemapmethodsPatternsmethodologicalgapscanprovideinsightfutureMATERIALSMETHODS:JoannaBriggsInstitutemethodologycustomtablesummarizedata:1demographicsyearcountrysetting2period3analysisstrategy4identifiedlimitationsrecommendations5qualityappraisal6Safety-IIemployedRESULTS:screened5879Onehundredfifteenmetinclusioncriteriaassessedeligibilityfull-textTwenty-seveneligibleDISCUSSIONCONCLUSION:foundlittleconsistencystudiedThreedesigns710across27NonesharedcombinationperiodsOutcomeneitherdefinedmeasuredconsistentlymaydifficultresearchersaggregatesynthesizefindingsstudiesoneoffermodelsupportconsistentapproachMethodsacutecare:frameworkresilienceengineeringsafety-II

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