Factors affecting registered nurses' use of medication administration technology in acute care settings: A systematic review.
BACKGROUND
Information technology to aid reduction in medication errors has been encouraged over the years and one of them is the medication administration technology. It consists of the electronic Medication Administration Record, Bar-Code Medication Administration system and Automated Medication Dispensing system. Studies had examined the effectiveness and impact of this technology to reduce medication error. However, user's acceptance towards this technology has often been neglected. To date, no systematic review has been undertaken to examine the possible factors that affect nurses' use of this technology in the acute care settings.


OBJECTIVE
The objective of this systematic review was to explore and determine the factors that affect nurses' use of medication administration technology in the acute care settings.


METHODS
All quantitative studies published in English which examined factors affecting nurses' use of the medication administration technology were considered.Primary focus was on registered nurses with experience of operating medication administration technology in the acute care settings. Other healthcare personnel were excluded.This review considered studies that evaluated factors affecting nurses' use of the medication administration technology.The outcome measures of interest were the factors that affect nurses' use of the medication administration technology in the acute care settings.


METHODS
The search was conducted across published and unpublished databases. A search was conducted in JBI Library of Systematic Reviews, The Cochrane Library, CINAHL, MEDLINE, Scopus, ScienceDirect, Wiley InterScience, SpringerLink, PsycINFO (ovid), Web of science, ProQuest Dissertations and Theses, and MedNar.


METHODS
Papers selected for retrieval were assessed by two independent reviewers for methodological validity prior to inclusion in the review, using the standardised critical appraisal instruments developed by the Joanna Briggs Institute.
Quantitative data were extracted from papers included in the review using a standardised data extraction tool developed by the JBI.


RESULTS
Findings were presented in narrative summary due to heterogeneity of the study designs.


RESULTS
Six descriptive studies were included in this review. Nurses' use of the technology can be influenced by a combination of complex and inter-related factors, such as organisational factors, and user and system characteristics.


CONCLUSIONS
In order to successfully implement medication administration technology, system, user and organisational factors have to be collaborated concurrently.Users' needs should be accommodated when designing the system features. Prior to system implementation, institutions should consider the users' demographical characteristics and provide adequate preparations and training. A supportive culture from the institution and colleagues is also important.There is a significant need for further research in this field. Further research to discover potential factors in different settings, locations and countries are suggested. Studies to evaluate nurses' use of the technology at regular intervals are also required.
1. The Singapore National University Hospital (NUH) Centre for Evidence Based Nursing, Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore: A Collaborating Centre of the Joanna Briggs Institute. 2. Deputy Director (Patient Safety), Standards & Quality Improvement Division, Ministry of Health, Singapore 3. Assistant Professor, PhD, CStat, Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore.
Tay Hui
TH
San
Serena Koh Siew
SK
Lin
Chan Moon
CM
Fai