Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies

Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies – Review the Resources and reflect on the impact of clinical systems on outcomes and efficiencies within the context of nursing practice and healthcare delivery…

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Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies

Paper details

• 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 5 peer-reviewed articles from your research.

The Assignment: (4-5 pages)

In a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. Be sure to address the following:

• Identify the 5 peer-reviewed articles you reviewed, citing each in APA format.
• 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.

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Solution

Literature Review

The Use of Clinical Systems to Improve Outcomes and Efficiencies

Critical care information systems play a pivotal role in the contemporary Intensive Care Units (ICU) by supporting essential processes of data processing, monitoring, and assessment. The increased efficiency subsequently improves clinical decision-making, staff satisfaction, length of stay and the quality of care. With studies underlining a 70% failure of health information technology (HIT) implementation, it is imperative to assess and examine the implementation, usability and application of critical care information systems in ICUs.

The review focuses on the impact of incorporating clinician perspectives during design and application of Critical Care Information System (CCIS) on patient outcome aspects such as length of stay, clinical decision making, communication and the staff performance. The articles were sourced from CINAHL, COCHRANE, and PubMed databases on peer-reviewed articles on Critical Care Information Systems (CCIS) and Intensive Care Information Systems (ICIS) in the last five years. The analysis summarizes each study, explains the improvement of outcomes, efficiencies, and lessons learned from the application of the critical care information system in each peer-reviewed article described.

Pamplin et al. (2020) assess the usability of a critical care information system that integrates electronic medical records with Novel Health Information Technology (NHIT) in critical care to facilitate clinical decisions. The study implemented a CCIS system that allows clinicians to customize displays according to their roles and information needs. The study is implemented in a 16-bed Care for Burn Intensive Care Unit (BICU), which extensively relies on collaborative efforts to attain optimal outcomes.

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The developed system incorporated 320 elements of information in the patient view and introduced text communication to facilitate team communication. To assess the usability of the system, the study recruited eleven physicians, twenty nurses, and ten respiratory therapists (RTs) who utilized the tools in critical care. The outcomes of the study showed that the clinicians found the system easier to use despite having minimal training and experience.

The study also noted that the information system improved clinical efficiency and team-based decision-making accuracy. The findings underline that information system, modified to target essential areas such as communication in the ICU, and could improve decision making and subsequently patient safety and outcomes. The study corresponds with Havel et al. (2019) findings that CCIS improve patient outcomes and safety, with this study emphasizing on improved decision making.

Qin et al. (2017) evaluated the design and implementation of an ICIS, with the input of nurses, to determine the impact of the system used on critical care nursing processes and outcomes. In a descriptive case study approach conducted in a 14-bed respiratory ICU, the participative design was used to incorporate nurses in the design of the ICIS system. Key aspects of the system were the full digitalization of nursing documentation with documentation time and quality being measured before and after system implementation.

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Qin et al. (2017) determine that nurses spent more time on patient, documentation was significantly improved, and the accuracy and administration of medication were also enhanced. On assessing key measures of ward performance, the study indicated a significant improvement in ward management, routine nursing practices, infection rate and mortality rate.

The study points out that the engagement of nurses in the development of the ICIS system makes it highly effective in improving efficiency and quality of care. The study differentially offers a rationale for engaging ICU nurses in the design of ICIS, showing that this lead to improved nursing performance also substantially improved patient outcomes. The key takeaway is on the engagement of ICU nurses on the design of information systems for optimal outcomes.

Hudson, Kushniruk, Borycki, & Zuege (2018) investigate the implementation of critical care clinical information systems to determine usability and clinician satisfaction. All physicians participated in a survey on usability and challenged to simulated scenarios. The study, applying a mixed-methods approach, determined that there was a moderate level of satisfaction with the critical care information system. Usability was highly limited by the layout and speed of the system.

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The findings highlight the importance of applying clinical systems with optimized speeds on both network and hardware. Besides, physician satisfaction was linked to the ability of the system to engage end-users actively. These are key factors in determining improvements in efficiencies and applicability of the systems in improving patient outcomes and making key processes more efficient. Moreover, the study underlines the importance of factoring in the perspectives of user-groups in the application of CCIS.

Havel, Selim, Besnier, Gouin, Veber, & Clavier, (2019) examine the impact of an intensive care information system on the length of stay in ICU. The study acknowledged that while ICIS is linked with reducing medical errors and improving patient safety, there is limited data on the impact of ICIS on the length of stay. Hence, the purpose of the study was to analyze the potential impact of an ICIS system on the length of stay of patients admitted in the ICU. The study utilized a before-after retrospective observational study on data of a total of 1,600 patients.

The data extracted included epidemiological data, the reason for ICU admission, severity score at admission, length of stay and mortality in ICU, mortality in hospital, use of life support during the stay, and ICU readmission during the same hospital stay. Through the variables and data extracted from medical records, the study was able to compare the average length of stay in surgical ICU before and after implementation of the ICIS system.

The results indicated that there was no significant difference in the length of stay between the two groups of patients. Further, the mortality and the readmission rates of the two groups did not differ significantly. In retrospect, the study noted that there was a significant increase in biological analyses leading to increasing costs.

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Findings by Havel et al. (2019) point out that intensive care information systems have no significant impact on the length of stay but rather reduce medical errors and improve patient safety. On the other hand, the study links the ease of prescription brought about by the system to over-prescription and increased biological analyses and costs. Havel et al., (2019) points out that despite the efficiency and changes of ICIS, there was no impact on the length of stay. However, it is imperative to perform a detailed assessment of the impact ICIS has on prescriptions.

Von Dincklage et al. (2018) investigate the functional requirements of critical care information systems (CCIS) from the users’ perspective. The study intended to provide a recommendation on the minimum range of functions that CCIS should incorporate per the perspectives of clinical ICU staff. Based on a web-based survey targeting clinical ICU staff, the study reports on the findings of a sample of 912 ICU practitioners that shows that more clinical users preferred to use CCIS to support patient admission and routine treatment for both nurses and physicians, and on organ-specific management.

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The study is highly beneficial as it highlights the perspectives of a large cohort of ICU practitioners on the most imperative functions of a CCIS system. For effective implementation, CCIS should aim at ensuring they offer value and efficiency to the clinical user. This directly contributes to the better usability, attitudes and implementation of the system.

Conclusion

Critical care information systems can effectively improve patient safety, quality of care, reduce medication errors, and improve nurse performance. However, the design and implementation process has to factor in the perspectives of clinician users who apply the systems in different processes. The review indicates that it is imperative to engage clinicians in the design and implementation process, to determine focus areas as this improves nursing performance, increases chances of success in the critical ICU, sustains high user satisfaction levels and significantly improves patient outcomes in the ICU such as safety and quality of care.

References

• Havel, C., Selim, J., Besnier, E., Gouin, P., Veber, B., & Clavier, T. (2019). Impact of an Intensive Care Information System on the Length of Stay of Surgical Intensive Care Unit Patients: Observational Study. JMIR Perioperative Medicine, 2(2), e14501. doi:10.2196/14501
• Hudson, D., Kushniruk, A., Borycki, E., & Zuege, D. J. (2018). Physician satisfaction with a critical care clinical information system using a multimethod evaluation of usability. International journal of medical informatics, 112, 131-136. DOI: 10.1016/j.ijmedinf.2018.01.010
• As you continue privateEssaywriters.com has the top and most qualified writers to help with any of your assignments including how to manage stress in workplaces. All you need to do is place an order with us (Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies).
• Pamplin, J., Nemeth, C. P., Serio-Melvin, M. L., Murray, S. J., Rule, G. T., Veinott, E. S., … & Salinas, J. (2020). Improving clinician decisions and communication in critical care using novel information technology. Military Medicine, 185(1-2), e254-e261. https://doi.org/10.1093/milmed/usz151
• Qin, Y., Zhou, R., Wu, Q., Huang, X., Chen, X., Wang, W., … & Bai, C. (2017). The effect of nursing participation in the design of a critical care information system: a case study in a Chinese hospital. BMC medical informatics and decision making, 17(1), 165. https://doi.org/10.1186/s12911-017-0569-3
• Von Dincklage, F., Suchodolski, K., Lichtner, G., Friesdorf, W., Podtschaske, B., & Ragaller, M. (2018). Functional requirements of critical care information systems (CCIS) from the users’ perspective. International journal of medical informatics, 120, 8–13. https://doi.org/10.1016/j.ijmedinf.2018.09.018

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