Abstract
BackgroundThe aim of this systematic review was to synthesise peer-reviewed literature assessing the impact of electronic prescribing (eP) systems on the working practices of healthcare professionals (HCPs) in the inpatient setting and identify implications for practice and research.MethodsWe searched PubMed, Medline, Embase, Cochrane and the Cumulative Index to Nursing Allied Health Literature databases for studies published from inception to November 2018. We included controlled, uncontrolled, observational and descriptive studies that explored the effect of eP on HCPs’ working practices in an inpatient setting. Data on setting, eP system and impact on working practices were extracted. Methodological quality was assessed using the Mixed Methods Appraisal Tool. Emergent themes were identified and subjected to narrative synthesis. The protocol was registered with PROSPERO (registration CRD42017075804).ResultsSearches identified 1301 titles and abstracts after duplicate removal. 171 papers underwent full-text review. A total of 25 studies met the inclusion criteria, from nine different countries. Nineteen were of commercial eP systems. There were a range of study designs; most (n = 14) adopted quantitative methods such as cross-sectional surveys, ten adopted qualitative approaches and a further one used mixed methods. Fourteen of the 25 studies were deemed to be of high quality. Four key themes were identified: communication, time taken to complete tasks, clinical workflow, and workarounds. Within each theme, study findings differed as to whether the effects of eP on HCPs’ working practices were positive or negative.ConclusionThere is a lack of consensus within the literature on the impact of eP on HCPs’ working practices. Future research should explore the strategies resulting in a positive impact on HCPs’ working practices and learn from those that have not been successful.
Highlights
The aim of this systematic review was to synthesise peer-reviewed literature assessing the impact of electronic prescribing systems on the working practices of healthcare professionals (HCPs) in the inpatient setting and identify implications for practice and research
Our aim was to synthesise peerreviewed literature assessing the impact of electronic prescribing (eP) systems on the working practices of HCPs in the inpatient setting and identify implications for practice and research
Pharmacists play a key role in the medication use process in most hospital inpatient settings and are significant users of eP systems; future research should explore the impact of eP on their working practices
Summary
The aim of this systematic review was to synthesise peer-reviewed literature assessing the impact of electronic prescribing (eP) systems on the working practices of healthcare professionals (HCPs) in the inpatient setting and identify implications for practice and research. To the best of our knowledge, there have been no previous systematic reviews exploring the effects of eP on the working practices of HCPs. For the purposes of this review, ‘working practices’ were considered to refer to HCPs conducting clinical work, diagnostics, monitoring, and/or interacting and communicating with other HCPs. Our aim was to synthesise peerreviewed literature assessing the impact of eP systems on the working practices of HCPs in the inpatient setting and identify implications for practice and research
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