scholarly journals Computer-based Guideline Implementation Systems: A Systematic Review of Functionality and Effectiveness

1999 ◽  
Vol 6 (2) ◽  
pp. 104-114 ◽  
Author(s):  
R. N. Shiffman ◽  
Y. Liaw ◽  
C. A. Brandt ◽  
G. J. Corb
Keyword(s):  
Systematic Review ◽  
Guideline Implementation ◽  
Computer Based

scholarly journals How effective are electronic medication systems in reducing medication error rates and associated harm among hospital inpatients? A systematic review and meta-analysis

2020 ◽  
Author(s):  
Peter J Gates ◽  
Rae-Anne Hardie ◽  
Magdalena Z Raban ◽  
Ling Li ◽  
Johanna I Westbrook
Keyword(s):  
Systematic Review ◽  
Medication Error ◽  
Medication Errors ◽  
Meta Analysis ◽  
Error Rates ◽  
Prescribing Error ◽  
Before And After ◽  
Actual Harm ◽  
Computer Based ◽  
Wide Scale

Abstract Objective To conduct a systematic review and meta-analysis to assess: 1) changes in medication error rates and associated patient harm following electronic medication system (EMS) implementation; and 2) evidence of system-related medication errors facilitated by the use of an EMS. Materials and Methods We searched Medline, Scopus, Embase, and CINAHL for studies published between January 2005 and March 2019, comparing medication errors rates with or without assessments of related harm (actual or potential) before and after EMS implementation. EMS was defined as a computer-based system enabling the prescribing, supply, and/or administration of medicines. Study quality was assessed. Results There was substantial heterogeneity in outcomes of the 18 included studies. Only 2 were strong quality. Meta-analysis of 5 studies reporting change in actual harm post-EMS showed no reduced risk (RR: 1.22, 95% CI: 0.18–8.38, P = .8) and meta-analysis of 3 studies reporting change in administration errors found a significant reduction in error rates (RR: 0.77, 95% CI: 0.72–0.83, P = .004). Of 10 studies of prescribing error rates, 9 reported a reduction but variable denominators precluded meta-analysis. Twelve studies provided specific examples of system-related medication errors; 5 quantified their occurrence. Discussion and Conclusion Despite the wide-scale adoption of EMS in hospitals around the world, the quality of evidence about their effectiveness in medication error and associated harm reduction is variable. Some confidence can be placed in the ability of systems to reduce prescribing error rates. However, much is still unknown about mechanisms which may be most effective in improving medication safety and design features which facilitate new error risks.

scholarly journals Computer-based HIV adherence promotion interventions: a systematic review

2015 ◽  
Vol 5 (3) ◽  
pp. 294-306 ◽  
Author(s):  
Kasey R. Claborn ◽  
Anne Fernandez ◽  
Tyler Wray ◽  
Susan Ramsey
Keyword(s):  
Systematic Review ◽  
Computer Based

Computer-Based Rehabilitation for Developing Speech and Language in Hearing-Impaired Children: A Systematic Review

2014 ◽  
Vol 17 (2) ◽  
pp. 111-119 ◽  
Author(s):  
Andrea Simpson ◽  
Amr El-Refaie ◽  
Caitlin Stephenson ◽  
Yi-Ping Phoebe Chen ◽  
Dennis Deng ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hearing Impaired ◽  
Speech And Language ◽  
Computer Based ◽  
Impaired Children ◽  
Hearing Impaired Children

scholarly journals The effectiveness of guideline implementation strategies in the dental setting: a systematic review

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Amy R. Villarosa ◽  
Della Maneze ◽  
Lucie M. Ramjan ◽  
Ravi Srinivas ◽  
Michelle Camilleri ◽  
...  
Keyword(s):  
Systematic Review ◽  
Guideline Adherence ◽  
Pay For Performance ◽  
Guideline Implementation ◽  
Implementation Strategies ◽  
Audit And Feedback ◽  
Dental Practice ◽  
Practice Setting ◽  
Dental Setting ◽  
Multifaceted Interventions

Abstract Background Guideline implementation has been an ongoing challenge in the dental practice setting. Despite this, there are no reviews summarising the existing evidence regarding effective guideline implementation strategies in this setting. In order to address this, this systematic review examines the effectiveness of guideline implementation strategies in the dental practice setting. Methods A systematic search was undertaken according to the PRISMA statement across nine electronic databases, targeting randomised controlled trials and quasi-experimental studies which evaluated the effectiveness of guideline implementation strategies in improving guideline adherence in the dental setting. All records were independently examined for relevance and appraised for study quality by two authors, with consensus achieved by a third author. Data were extracted from included studies using a standardised data extraction pro forma. Results A total of 15 records were eligible for inclusion in this review, which focused on the effects of audit and feedback, reminders, education, patient-mediated interventions, pay for performance and multifaceted interventions. Although there were some conflicting evidence, studies within each category of implementation strategy indicated a positive effect on guideline adherence. Conclusions This study has identified education, reminders and multifaceted interventions as effective implementation strategies for the dental practice setting. Although this is similar to research findings from other health sectors, there is some evidence to suggest patient-mediated interventions may be less effective and pay for performance may be more effective in the dental setting. These findings can inform policy makers, professional associations, colleges and organisations in the future adoption of clinical guidelines in the dental practice setting. Trial registration This systematic review was registered with the International Prospective Register of Systematic Reviews (PROSPERO), registration ID CRD42018093023.

scholarly journals A systematic review using the Theoretical Domains Framework to identify barriers and facilitators to the adoption of prescribing guidelines

2020 ◽  
Author(s):  
Paulina Paksaite ◽  
Joel Crosskey ◽  
Eni Sula ◽  
Celine West ◽  
Margaret Watson
Keyword(s):  
Systematic Review ◽  
Peer Influence ◽  
Guideline Implementation ◽  
Theoretical Domains Framework ◽  
Barriers And Facilitators ◽  
Healthcare Settings ◽  
Prescribing Quality ◽  
Behavioural Factors ◽  
Time Restriction ◽  
Evidence Based Guidelines

Abstract Objectives Evidence-based guidelines have the potential to reduce variation and increase prescribing quality. Identifying the key determinants to their uptake, using a theory-based approach, may assist in the design of successful interventions to increase their adoption into practice. This systematic review investigated barriers and facilitators identified using the Theoretical Domains Framework (TDF) to the implementation of prescribing guidelines. Methods Electronic databases (EMBASE, PubMed) were searched. Studies were included if they used the TDF to identify key determinants of guideline implementation. Only studies published in English were included. Key findings Of the 407 studies identified, 15 were included. A range of patient populations and therapeutic categories were represented. Multiple determinants were identified that affected guideline implementation, with similarities and differences identified across studies. Barriers to guideline adoption included time restriction, lack of awareness, guideline complexity, lack of clinical evidence, social influences and disagreement. Facilitators included peer influence, guideline simplicity, confidence and belief about the positive consequences derived from guideline adoption, for examples improved care and patient outcomes. Conclusions Multiple behavioural factors affect the adoption of prescribing guidelines. The results aided the understanding of factors that may be targeted to increase guideline compliance. However, barriers and facilitators can vary significantly in different environments; therefore, research that targets particular healthcare settings and patient populations may provide further evidence to increase the specificity and credibility of intervention strategies.

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