J Am Med Inform Assoc - Development and preliminary evidence for the validity of an instrument assessing implementation of human-factors principles in medication-related decision-support systems--I-MeDeSA.

Tópicos

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Resumo

CKGROUND: Medication-related decision support can reduce the frequency of preventable adverse drug events. However, the design of current medication alerts often results in alert fatigue and high over-ride rates, thus reducing any potential benefits.METHODS: The authors previously reviewed human-factors principles for relevance to medication-related decision support alerts. In this study, instrument items were developed for assessing the appropriate implementation of these human-factors principles in drug-drug interaction (DDI) alerts. User feedback regarding nine electronic medical records was considered during the development process. Content validity, construct validity through correlation analysis, and inter-rater reliability were assessed.RESULTS: The final version of the instrument included 26 items associated with nine human-factors principles. Content validation on three systems resulted in the addition of one principle (Corrective Actions) to the instrument and the elimination of eight items. Additionally, the wording of eight items was altered. Correlation analysis suggests a direct relationship between system age and performance of DDI alerts (p=0.0016). Inter-rater reliability indicated substantial agreement between raters (=0.764).CONCLUSION: The authors developed and gathered preliminary evidence for the validity of an instrument that measures the appropriate use of human-factors principles in the design and display of DDI alerts. Designers of DDI alerts may use the instrument to improve usability and increase user acceptance of medication alerts, and organizations selecting an electronic medical record may find the instrument helpful in meeting their clinicians' usability needs.

Resumo Limpo

ckground medicationrel decis support can reduc frequenc prevent advers drug event howev design current medic alert often result alert fatigu high overrid rate thus reduc potenti benefitsmethod author previous review humanfactor principl relev medicationrel decis support alert studi instrument item develop assess appropri implement humanfactor principl drugdrug interact ddi alert user feedback regard nine electron medic record consid develop process content valid construct valid correl analysi interrat reliabl assessedresult final version instrument includ item associ nine humanfactor principl content valid three system result addit one principl correct action instrument elimin eight item addit word eight item alter correl analysi suggest direct relationship system age perform ddi alert p interrat reliabl indic substanti agreement rater conclus author develop gather preliminari evid valid instrument measur appropri use humanfactor principl design display ddi alert design ddi alert may use instrument improv usabl increas user accept medic alert organ select electron medic record may find instrument help meet clinician usabl need

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