Clinical reminder alert fatigue in healthcare: a systematic literature review protocol using qualitative evidence.
Clinical reminder alert fatigue in healthcare: a systematic literature review protocol using qualitative evidence.
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DOI：
10.1186/s13643-017-0627-z
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发表时间：
2017-12-13
影响因子：
3.7
通讯作者：
Litchfield I
中科院分区：
文献类型：
--
作者：
Backman R;Bayliss S;Moore D;Litchfield I
由于使用电子健康记录和证据表明实践中的合规性增加，临床系统中的集成提醒变得更加普遍。临床提示的有效性是根据个体情况进行评估的，而不是与其他情况的现有提示相结合。越来越多的提示可能会适得其反，因为医疗保健专业人员越来越患有“提醒疲劳”，这意味着许多提醒被忽略。这项工作将审查定性证据，以确定计算机化决策支持系统中现有提示的障碍和推动因素。我们的重点将是初级保健，临床医生必须协商过多的提醒，因为他们处理越来越复杂的病人和复杂的治疗方案。该审查将提供对现有系统的更好理解以及临床医生与它们互动的方式，以告知更有效和有针对性的临床提醒的开发。将使用试点术语进行全面检索，以识别1960年（或数据库开始）至2017年的相关文献。将检索MEDLINE、MEDLINE In Process、EMBASE、HMIC、PsycINFO、CDSR DARE、HTA、CINAHL和CPCI，以及灰色文献和参考文献以及纳入论文的引文。将使用CASP工具评估受试者的合格性、偏倚和质量，纳入叙述性数据，排除基于问卷的研究。将进行归纳性主题分析，以产生一个概念框架，定义围绕综合临床提示的关键障碍。在当前的文献中可以找到警报和提醒疲劳的迹象。然而，这还没有得到充分的调查，使用一个强大的定性方法，特别是在一个快速增长的证据。这一审查将帮助人们形成新的临床系统，以便警报可以适当地纳入。- 你好CRD 42016029418本文的在线版本（10.1186/s13643-017-0627-z）包含补充材料，可供授权用户使用。
Integrated reminders within clinical systems have become more prevalent due to the use of electronic health records and evidence demonstrating an increase in compliance within practice. Clinical reminders are assessed for effectiveness on an individual basis, rather than in combination with existing prompts for other conditions. The growing number of prompts may be counter-productive as healthcare professionals are increasingly suffering from “reminder fatigue” meaning many reminders are ignored. This work will review the qualitative evidence to identify barriers and enablers of existing prompts found within computerised decision support systems. Our focus will be on primary care where clinicians have to negotiate a plethora of reminders as they deal with increasingly complex patients and sophisticated treatment regimes. The review will provide a greater understanding of existing systems and the way clinicians interact with them to inform the development of more effective and targeted clinical reminders. A comprehensive search using piloted terms will be used to identify relevant literature from 1960 (or commencement of database) to 2017. MEDLINE, MEDLINE In Process, EMBASE, HMIC, PsycINFO, CDSR DARE, HTA, CINAHL and CPCI, will be searched, as well as grey literature and references and citations of included papers. Manuscripts will be assessed for eligibility, bias and quality using the CASP tool with narrative data being included and questionnaire based studies excluded. Inductive thematic analysis will be performed in order to produce a conceptual framework defining the key barriers around integrated clinical reminders. Indications of alert and reminder fatigue are found throughout the current literature. However, this has not been fully investigated using a robust qualitative approach, particularly in a rapidly growing body of evidence. This review will aid people forming new clinical systems so that alerts can be incorporated appropriately. PROSPERO: CRD42016029418 The online version of this article (10.1186/s13643-017-0627-z) contains supplementary material, which is available to authorized users.
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DOI：
10.1136/bmj.b2535
发表时间：
2009-07-21
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Moher D;Liberati A;Tetzlaff J;Altman DG;PRISMA Group
通讯作者：
PRISMA Group
DOI：
10.1197/jamia.m2555
发表时间：
2008-05-01
影响因子：
6.4
作者：
Dexheimer, Judith W.;Talbot, Thomas R.;Aronsky, Dominik
通讯作者：
Aronsky, Dominik
影响因子：
--
作者：
Ariza, Ferran;Kalra, Dipak;Potts, Henry Ww
通讯作者：
Potts, Henry Ww
影响因子：
6.7
作者：
Hughes, Lloyd D.;McMurdo, Marion E. T.;Guthrie, Bruce
通讯作者：
Guthrie, Bruce
影响因子：
1.3
作者：
Brokel, Jane M.;Schwichtenberg, Tamara J.;Kramer, J. Michael
通讯作者：
Kramer, J. Michael