How to write an annotated bibliography on Technologies Supporting Applied Practice and Optimal Patient Outcomes (Solved)

Annotated Bibliography prompt: 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.”

Develop an annotated bibliography that follows the organization of the Sample Annotated Bibliography resource provided in this Competency.
Complete the annotated bibliography for each of the five peer-reviewed articles you selected for the one type of clinical system you selected. Be sure to include the following:
An introduction of each peer-reviewed article selected.
APA citation of each peer-reviewed article selected.
Summarize the study in each peer-reviewed article selected.
Analyze each peer-reviewed article selected. What are the benefits and limitations of each peer-reviewed article?
Explain the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system that each peer-reviewed article described. Be specific and provide examples

SOLUTION TO THE ANNOTATED BIBLIOGRAPHY ON Clinical Information Systems

Article 1

Kruse, C. S., Stein, A., Thomas, H., & Kaur, H. (2018). The use of electronic health records to support population health: A systematic review of the literature. Journal of Medical Systems, 42(11), 214. https://doi.org/10.1007/s10916-018-1075-6

Electronic health records have emerged among the top health information technologies (HIT) to improve quality, efficiency, and disparities in population health. While providing reasonable improvements in healthcare, various challenges with interoperability, functionality, and medical errors are observed. The focus of this article is to assess the relationship of EHRs use on population health through identification and analysis of facilitators and barriers to its adoption. The systematic review analyzed articles from CINAHL, MEDLINE, and PubMed.

Incorporating EHRs in surveillance and care interventions can help aid the health of populations served. Upon analysis of different studies, the authors observed that EHRs have been essential in promoting productivity, quality, data management, and preventive healthcare (Kruse et al., 2018). The implementation of EHRs across different facilities has improved the delivery and integration of healthcare services using modern technology. With a focus on areas like the ICU, EHRs were observed to lower central line-associated healthcare infections (CLABSI) and mortality rates within the surgical ICU (Kruse et al., 2018). Additionally, the systems have helped reduce data fragmentation to aid in the assessment, diagnosis, and follow-up for patients with diabetes and other chronic diseases.

The lesson learned from this study is that EHRs can potentially improve patient outcomes across different healthcare areas. The systems facilitate safe continuity of care and can be used to address challenging areas of care delivery that have long been problems to healthcare providers. For example, lowering CLABSI and mortality rates in the ICU is an area that poses a lot of challenges across all healthcare institutions. The study demonstrates that EHRs can be applied to improve clinical outcomes and efficiencies in healthcare.

Article 2

Selvaraj, S., Fonarow, G. C., Sheng, S., Matsouaka, R. A., DeVore, A. D., Heidenreich, P. A., Hernandez, A. F., Yancy, C. W., & Bhatt, D. L. (2018). Association of electronic health record use with quality of care and outcomes in heart failure: An analysis of get with the guidelines-heart failure. Journal of the American Heart Association, 7(7), e008158. https://doi.org/10.1161/JAHA.117.008158

The adoption of EHRs has increased significantly across the nation to promote meaningful use of health information systems. Numerous theoretical benefits of EHRs including improved care coordination reduced medical errors, and rapid analysis of quality measures have been reported. One area that can benefit from the use of EHRs is heart failure (HF) which is a significant cause of mortality and morbidity in the US. This article analyzed the implementation of EHRs to improve quality care and reduce mortality during hospital admission and 30-day readmission for patients with HF. Participants from the Get With The Guidelines- HF registry admitted in 2008 were analyzed.

In a large national registry of more than 20,000 patients, the researchers observed no significant impact of EHRs in improving patient-level quality metrics associated with HF (Selvaraj et al., 2018). It was observed that providers spent more time interacting with the system rather than focusing on patient care. Other studies involved in the analysis demonstrated significant improvement in certain areas like beta-blocker administration at discharge. Overall, EHRs were not associated with improved quality of care in hospital outcomes and post-discharge events.

The study results in the selected article should be interpreted in the context of a few limitations. For example, the researchers only focused on hospitals participating in the GWTG-HF program making the results inapplicable in other facilities (Selvaraj et al., 2018). The lesson I learned from this article is that EHRs alone cannot address specific healthcare problems like heart failure. While implementing EHRs in healthcare, other interventions may be required to monitor patients and make decisions that can improve patient outcomes related to HF.

Article 3

Koo, J. K., Moyer, L., Castello, M. A., & Arain, Y. (2020). Improving accuracy of handoff by implementing an electronic health record-generated tool: An improvement project in an academic neonatal intensive care unit. Pediatric Quality & Safety, 5(4), e329. https://doi.org/10.1097/pq9.0000000000000329

Electronic-based documentation is considered a major transformation in healthcare across many hospitals worldwide. One of the areas that have greatly improved due to EHR adoption is shift handoffs and the exchange of information between nurses and other healthcare providers. Formulation of a standardized EHR tool for shift handoff was the central focus of this research. The study utilized the PDSA cycle and involved various participants including registered nurses, neonatal nurse practitioners, neonatal hospitalists, pediatric residents, neonatal fellows, and neonatologists.

Supplementing verbal documentation with additional handoff tools may help reduce errors in healthcare. The adoption of handout printouts generated by EHRs improved the accuracy of patient data points from 51% to 97% (Koo et al., 2020). At the same period, the researchers observed that medication errors decreased by a wide margin due to improved communication of information. The use of EHR-generated handoff printouts demonstrated fewer inaccuracies compared to manual scripted versions.

The lesson learned from the study is that using EHRs can aid in the standardization of shift handoffs to improve patient outcomes. One limitation of the study is that the tool was only designed for one healthcare facility and may not demonstrate similar results in other institutions (Koo et al., 2020). From this article, we learn that EHRs can improve standardization of processes like shift handoffs in healthcare leading to desirable patient outcomes.

Article 4

Jindal, S. K., & Raziuddin, F. (2018). Electronic medical record use and perceived medical error reduction. International Journal of Quality and Service Sciences. https://doi.org/10.1108/IJQSS-12-2016-0081

Electronic health records have largely replaced written medical records in hospitals across the country to reduce human error that impairs patient outcomes. The focus of this study was to present findings on the relevance of EHRs in reducing medical errors. The researchers collected views from 99 medical professionals from Arizona that used EHRs to manage their patients.

It was observed that many agreed on the relevance of EHRs in monitoring patient surgeries including reduction of wrong-site surgery and improper dosage delivery to patients (Jindal & Raziuddin, 2018). EHRs can automatically update patients’ information that is required on a routine basis via different computing systems such as cloud, minimizing the need for information technology professionals to handle the issues. Overall, there was a 50-60% reduction in medical errors with the use of EHRs.

The study findings have some limitations, especially because it was based on the perceived benefits of the technology. The information used only relied on the perceptions of physicians rather than conducting database searches to find other outcomes related to EHR use. The lesson learned from the research is that EHRs can lead to reduced cost, increased efficiency, effectiveness, and better management of the patient’s health is well-utilized. This study is beneficial to healthcare professionals because it indicates the positive impact of EHRs in addressing medical errors. Socially, the technology can be crucial in reducing healthcare costs and increasing efficiency in healthcare delivery.

Article 5

Aldosari, B. (2017). Patients’ safety in the era of EMR/EHR automation. Informatics in Medicine Unlocked, 9, 230-233. https://doi.org/10.1016/j.imu.2017.10.001

Electronic health records were introduced to aid physicians and healthcare institutions in imparting quality healthcare to patients. The systems record and store information about patients including demographics, progress notes, medications, and investigations. This study aimed at assessing the aspect of patient safety that emerges from EHR use. The researchers analyzed current evidence from numerous qualitative studies to determine the impact of EHRs in improving patient safety.

It was observed that the incorporation of the clinical decision support system (CDS) features in the EHR system improves decision-making in healthcare (Aldosari, 2017). The use of EHRs has guided the following of clinical practice guidelines that improve patient safety. Additionally, EHRs can alert providers during safety events like medication errors and guide physicians and nurses in making the right choices during care delivery.

The aspects of patient safety addressed in the article included reduced medication errors and improved decision-making with the aid of other systems like CDS. The lesson learned from this study is that EHRs may require support with other technologies to improve the efficiency of healthcare service delivery (Aldosari, 2017). Healthcare institutions need to adopt supportive systems like the CDC and CPOE to the EHR to aid in improving patent safety.

Conclusion

Clinical information systems have generated opportunities for meaningful improvement in evidence-based and patient-centered health care. From the above evidence, it is observed that the main function of the EHR system is to capture, store, process, and transfer information to decision-makers in healthcare. These systems present an opportunity for the healthcare industry to standardize care to align with the increasing demands for quality services today. While working towards the meaningful use of EHRs, providers must incorporate supportive technologies like CDC to achieve more desirable results.

References

Aldosari, B. (2017). Patients’ safety in the era of EMR/EHR automation. Informatics in Medicine Unlocked, 9, 230-233. https://doi.org/10.1016/j.imu.2017.10.001

How to write an annotated bibliography on Technologies Supporting Applied Practice and Optimal Patient Outcomes (Solved)

SOLUTION TO THE ANNOTATED BIBLIOGRAPHY ON Clinical Information Systems

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