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Appl Clin Inform 2023; 14(01): 185-198
DOI: 10.1055/s-0043-1761435
Review Article

A Systematic Review of Quantitative Methods for Evaluating Electronic Medication Administration Record and Bar-Coded Medication Administration Usability

Zoe M. Pruitt   *
1   National Center for Human Factors in Healthcare, MedStar Health Research Institute, Washington, District of Columbia, United States
,
Sadaf Kazi   *
1   National Center for Human Factors in Healthcare, MedStar Health Research Institute, Washington, District of Columbia, United States
2   Department of Emergency Medicine, Georgetown University School of Medicine, Washington, District of Columbia, United States
,
Charlene Weir
3   Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah, United States
,
Teresa Taft
3   Department of Biomedical Informatics, University of Utah, Salt Lake City, Utah, United States
,
Deanna-Nicole Busog
1   National Center for Human Factors in Healthcare, MedStar Health Research Institute, Washington, District of Columbia, United States
,
Raj Ratwani
1   National Center for Human Factors in Healthcare, MedStar Health Research Institute, Washington, District of Columbia, United States
2   Department of Emergency Medicine, Georgetown University School of Medicine, Washington, District of Columbia, United States
,
Aaron Z. Hettinger
1   National Center for Human Factors in Healthcare, MedStar Health Research Institute, Washington, District of Columbia, United States
2   Department of Emergency Medicine, Georgetown University School of Medicine, Washington, District of Columbia, United States
› Author Affiliations Funding U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality, grant number: R01HS025136.
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Abstract

Background Although electronic medication administration records (eMARs) and bar-coded medication administration (BCMA) have improved medication safety, poor usability of these technologies can increase patient safety risks.

Objectives The objective of our systematic review was to identify the impact of eMAR and BCMA design on usability, operationalized as efficiency, effectiveness, and satisfaction.

Methods We retrieved peer-reviewed journal articles on BCMA and eMAR quantitative usability measures from PsycInfo and MEDLINE (1946–August 20, 2019), and EMBASE (1976–October 23, 2019). Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we screened articles, extracted and categorized data into the usability categories of effectiveness, efficiency, and satisfaction, and evaluated article quality.

Results We identified 1,922 articles and extracted data from 41 articles. Twenty-four articles (58.5%) investigated BCMA only, 10 (24.4%) eMAR only, and seven (17.1%) both BCMA and eMAR. Twenty-four articles (58.5%) measured effectiveness, 8 (19.5%) efficiency, and 17 (41.5%) satisfaction. Study designs included randomized controlled trial (n = 1; 2.4%), interrupted time series (n = 1; 2.4%), pretest/posttest (n = 21; 51.2%), posttest only (n = 14; 34.1%), and pretest/posttest and posttest only for different dependent variables (n = 4; 9.8%). Data collection occurred through observations (n = 19, 46.3%), surveys (n = 17, 41.5%), patient safety event reports (n = 9, 22.0%), surveillance (n = 6, 14.6%), and audits (n = 3, 7.3%).

Conclusion Of the 100 measures across the 41 articles, implementing BCMA and/or eMAR broadly resulted in an increase in measures of effectiveness (n = 23, 52.3%) and satisfaction (n = 28, 62.2%) compared to measures of efficiency (n = 3, 27.3%). Future research should focus on eMAR efficiency measures, utilize rigorous study designs, and generate specific design requirements.

Keywords

testing - evaluation - medication management - BCMA - medication administration record - interface - usability - satisfaction - quantitative

Protection of Human and Animal Subjects

Human and/or animal subjects were not included in this research.


* Joint first authors.


Supplementary Material



Publication History

Received: 17 August 2022

Accepted: 20 December 2022

Article published online:
08 March 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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