Comparative evaluation of different medication safety measures for the emergency department: physicians' usage and acceptance of training, poster, checklist and computerized decision support.
Comparative evaluation of different medication safety measures for the emergency department: physicians' usage and acceptance of training, poster, checklist and computerized decision support.
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DOI：
10.1186/1472-6947-13-79
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发表时间：
2013-07-29
影响因子：
3.5
通讯作者：
Bürkle T
中科院分区：
文献类型：
--
作者：
Sedlmayr B;Patapovas A;Kirchner M;Sonst A;Müller F;Pfistermeister B;Plank-Kiegele B;Vogler R;Criegee-Rieck M;Prokosch HU;Dormann H;Maas R;Bürkle T
虽然使用和接受是一个成功的实施药物临床决策支持系统的重要因素，大多数研究只集中在他们的设计和结果。我们的目的是比较研究一组传统的药物安全措施，如医生的药物安全培训，基于纸张的海报和检查表有关潜在的药物问题与计算机辅助药物检查的额外好处。我们集中在使用，接受和适用性等干预措施，在一个繁忙的忙碌急诊科（艾德）的749床急性三级保健医院。一个回顾性的，定性的评价研究进行了实地观察和基于问卷调查。在治疗20例患者病例时观察了6名医生; 9名艾德医生回答了基于技术接受模型2（TAM 2）的问卷。在现场观察期间，我们没有观察到直接使用任何已实施的药物安全干预措施（纸质和电子）。问卷调查结果显示，电子药物安全检查是最常用的干预措施，其次是检查表和海报。然而，尽管他们的积极态度，医生最常说，他们使用的干预措施，只有高达百分之十的主观“关键”的订单。使用率低的主要原因是缺乏易用性和适合工作流程。在克服这些障碍后，使用干预措施的意愿相当高。从方法上讲，这项研究有助于技术接受模型（TAM）的研究在艾德设置和确认TAM 2作为一个有用的诊断工具，在确定一个成功的实施药物安全干预的障碍。在我们的案例中，已确定的障碍解释了实施的药物安全干预措施的低利用率-尽管他们的积极接受-包括可及性，向医生介绍干预措施，易用性和兼容性的赤字工作环境。
Although usage and acceptance are important factors for a successful implementation of clinical decision support systems for medication, most studies only concentrate on their design and outcome. Our objective was to comparatively investigate a set of traditional medication safety measures such as medication safety training for physicians, paper-based posters and checklists concerning potential medication problems versus the additional benefit of a computer-assisted medication check. We concentrated on usage, acceptance and suitability of such interventions in a busy emergency department (ED) of a 749 bed acute tertiary care hospital. A retrospective, qualitative evaluation study was conducted using a field observation and a questionnaire-based survey. Six physicians were observed while treating 20 patient cases; the questionnaire, based on the Technology Acceptance Model 2 (TAM2), has been answered by nine ED physicians. During field observations, we did not observe direct use of any of the implemented interventions for medication safety (paper-based and electronic). Questionnaire results indicated that the electronic medication safety check was the most frequently used intervention, followed by checklist and posters. However, despite their positive attitude, physicians most often stated that they use the interventions in only up to ten percent for subjectively “critical” orders. Main reasons behind the low usage were deficits in ease-of-use and fit to the workflow. The intention to use the interventions was rather high after overcoming these barriers. Methodologically, the study contributes to Technology Acceptance Model (TAM) research in an ED setting and confirms TAM2 as a helpful diagnostic tool in identifying barriers for a successful implementation of medication safety interventions. In our case, identified barriers explaining the low utilization of the implemented medication safety interventions - despite their positive reception - include deficits in accessibility, briefing for the physicians about the interventions, ease-of-use and compatibility to the working environment.
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影响因子：
2.8
作者：
Boonstra A;Broekhuis M
通讯作者：
Broekhuis M
DOI：
10.1016/0749-5978(91)90020-t
发表时间：
1991-12-01
影响因子：
4.6
作者：
AJZEN, I
通讯作者：
AJZEN, I
DOI：
10.1145/65766.65768
发表时间：
1988-09-01
期刊：
DATA BASE
影响因子：
--
作者：
GOODHUE, D
通讯作者：
GOODHUE, D
影响因子：
5.3
作者：
Heselmans, Annemie;Aertgeerts, Bert;Ramaekers, Dirk
通讯作者：
Ramaekers, Dirk
影响因子：
3.5
作者：
AJZEN, I;MADDEN, TJ
通讯作者：
MADDEN, TJ