{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,13]],"date-time":"2026-09-13T00:22:21Z","timestamp":1789258941480,"version":"build-2803163510"},"reference-count":53,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Appl Clin Inform"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Background\u2003Seamless data integration between point-of-care medical devices and the electronic health record (EHR) can be central to clinical decision support systems (CDSS).<\/jats:p><jats:p>\n          Objective\u2003The objective of this scoping review is to (1) examine the existing evidence related to integrated medical devices, primarily medication pump devices, and associated clinical decision support (CDS) in acute care settings and (2) to identify how acute care clinicians may use device CDS in clinical decision-making. The rationale for this review is that integrated devices are ubiquitous in the acute care setting, and they generate data that may help to contribute to the situational awareness of the clinical team necessary to provide individualized patient care.<\/jats:p><jats:p>\n          Methods\u2003This scoping review was conducted using the Joanna Briggs Institute Manual for Evidence Synthesis and the Preferred Reporting Items for Systematic Reviews and Meta-analyses Extensions for Scoping Review guidelines. PubMed, CINAHL, IEEE Xplore, and Scopus databases were searched for scholarly, peer-reviewed journals indexed between January 1, 2010 and December 31, 2020. A priori inclusion criteria were established.<\/jats:p><jats:p>\n          Results\u2003Of the 1,924 articles screened, 18 were ultimately included for synthesis, and primarily included articles on devices such as intravenous medication pumps and vital signs machines. Clinical alarm burden was mentioned in most of the articles, and despite not including the term \u201cmedication\u201d there were many articles about smart pumps being integrated with the EHR. The Revised Technology, Nursing &amp; Patient Safety Conceptual Model provided the organizational framework. Ten articles described patient assessment, monitoring, or surveillance use. Three articles described patient protection from harm. Four articles described direct care use scenarios, all of which described insulin administration. One article described a hybrid situation of patient communication and monitoring. Most of the articles described devices and decision support primarily used by registered nurses (RNs).<\/jats:p><jats:p>\n          Conclusion\u2003The articles in this review discussed devices and the associated CDSS that are used by clinicians, primarily RNs, in the daily provision of care for patients. Integrated device data provide insight into user\u2013device interactions and help to illustrate health care processes, especially the activities when providing direct care to patients in an acute care setting. While there are CDSS designed to support the clinician while working with devices, RNs and providers may disregard this guidance, and defer to their own expertise. Additionally, if clinicians perceive CDSS as intrusive, they are at risk for alarm and alert fatigue if CDSS are not tailored to sync with the workflow of the end-user. Areas for future research include refining inclusion criteria to examine the evidence for devices and their CDS that are most likely used by other groups' health care professionals (i.e., doctors and therapists), using integrated device metadata and deep learning analytics to identify patterns in care delivery, and decision support tools for patients using their own personal data.<\/jats:p>","DOI":"10.1055\/s-0042-1759513","type":"journal-article","created":{"date-parts":[[2022,12,29]],"date-time":"2022-12-29T00:05:21Z","timestamp":1672272321000},"page":"1223-1236","source":"Crossref","is-referenced-by-count":17,"title":["A Scoping Review of Integrated Medical Devices and Clinical Decision Support in the Acute Care Setting"],"prefix":"10.1055","volume":"13","author":[{"given":"Jennifer B.","family":"Withall","sequence":"additional","affiliation":[{"name":"Department of Nursing, Columbia University School of Nursing, New York, New York, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica M.","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Department of Nursing, Columbia University School of Nursing, New York, New York, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Usseglio","sequence":"additional","affiliation":[{"name":"Augustus C. Long Health Sciences Library, Columbia University Irving Medical Center, New York, New York, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenrick D.","family":"Cato","sequence":"additional","affiliation":[{"name":"Department of Nursing, Columbia University School of Nursing, New York, New York, United States"},{"name":"Department of Emergency Medicine, Columbia University Irving Medical Center, New York, New York, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2022,12,28]]},"reference":[{"key":"ref1","volume-title":"Institute of Medicine (US) Committee on Quality of Health Care in America, Kohn LT, Corrigan JM, Donaldson MS, eds. To Err is Human: Building a Safer Health System","year":"2000"},{"issue":"05","key":"ref3","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.1097\/AOG.0b013e31826feaa0","article-title":"Patient safety: some progress and many challenges","volume":"120","author":"P A Gluck","year":"2012","journal-title":"Obstet Gynecol"},{"issue":"05","key":"ref4","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1001\/jama.2016.7887","article-title":"Improving safety for hospitalized patients: much progress but many challenges remain","volume":"316","author":"R Kronick","year":"2016","journal-title":"JAMA"},{"issue":"05","key":"ref5","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1097\/MLR.0000000000000680","article-title":"Impact of Medicare's nonpayment program on hospital-acquired conditions","volume":"55","author":"C P Thirukumaran","year":"2017","journal-title":"Med Care"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"i2139","DOI":"10.1136\/bmj.i2139","article-title":"Medical error-the third leading cause of death in the US","volume":"353","author":"M A Makary","year":"2016","journal-title":"BMJ"},{"issue":"03","key":"ref7","first-page":"171","article-title":"Health Care 4.0: a vision for smart and connected health care","volume":"11","author":"J Li","year":"2021","journal-title":"IISE Trans Healthc Syst Eng"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"103517","DOI":"10.1016\/j.apergo.2021.103517","article-title":"Digital technologies: an exploratory study of their role in the resilience of healthcare services","volume":"97","author":"V Marques da Rosa","year":"2021","journal-title":"Appl Ergon"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"103584","DOI":"10.1016\/j.apergo.2021.103584","article-title":"Usability of smart infusion pumps: a heuristic evaluation","volume":"98","author":"A Klarich","year":"2022","journal-title":"Appl Ergon"},{"issue":"05","key":"ref10","doi-asserted-by":"crossref","first-page":"1120","DOI":"10.1055\/s-0041-1740256","article-title":"A mobile, electronic health record-connected application for managing team workflows in inpatient care","volume":"12","author":"J M Soegaard Ballester","year":"2021","journal-title":"Appl Clin Inform"},{"issue":"03","key":"ref11","first-page":"155","article-title":"Existing and emerging technologies for point-of-care testing","volume":"35","author":"A St John","year":"2014","journal-title":"Clin Biochem Rev"},{"issue":"06","key":"ref12","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1136\/jamia.2001.0080527","article-title":"Clinical decision support systems for the practice of evidence-based medicine","volume":"8","author":"I Sim","year":"2001","journal-title":"J Am Med Inform Assoc"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1038\/s41746-020-0221-y","article-title":"An overview of clinical decision support systems: benefits, risks, and strategies for success","volume":"3","author":"R T Sutton","year":"2020","journal-title":"NPJ Digit Med"},{"key":"ref14","volume-title":"Scoping reviews (2020 version)","author":"M DJ Peters","year":"2020"},{"issue":"07","key":"ref15","doi-asserted-by":"crossref","first-page":"467","DOI":"10.7326\/M18-0850","article-title":"PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation","volume":"169","author":"A C Tricco","year":"2018","journal-title":"Ann Intern Med"},{"issue":"48","key":"ref16","first-page":"759","article-title":"Patient protection and affordable care act","volume":"111","author":"P Protection","year":"2010","journal-title":"Public Law"},{"key":"ref17","volume-title":"Patient Care Technology and Safety","author":"G Powell-Cope","year":"2008"},{"issue":"04","key":"ref18","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1111\/j.1468-0009.2005.00397.x","article-title":"Evaluating the quality of medical care. 1966","volume":"83","author":"A Donabedian","year":"2005","journal-title":"Milbank Q"},{"issue":"10","key":"ref19","doi-asserted-by":"crossref","first-page":"2069","DOI":"10.1088\/0967-3334\/36\/10\/2069","article-title":"Multiple physical signs detection and decision support system for hospitalized older adults","volume":"36","author":"M M Baig","year":"2015","journal-title":"Physiol Meas"},{"issue":"01","key":"ref20","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1177\/2516043519893228","article-title":"Automation and interoperability of a nurse-managed insulin infusion protocol as a model to improve safety and efficiency in the delivery of high-alert medications","volume":"25","author":"N Barasch","year":"2020","journal-title":"J Patient Saf Risk Manag"},{"issue":"03","key":"ref21","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1097\/ANC.0000000000000690","article-title":"Development of an alarm algorithm, with nanotechnology multimodal sensor, to predict impending infusion failure and improve safety of peripheral intravenous catheters in neonates","volume":"20","author":"E M Bosque","year":"2020","journal-title":"Adv Neonatal Care"},{"issue":"12","key":"ref22","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1016\/j.ijmedinf.2011.10.003","article-title":"Barriers and facilitators to the use of computer-based intensive insulin therapy","volume":"80","author":"T R Campion Jr.","year":"2011","journal-title":"Int J Med Inform"},{"issue":"02","key":"ref23","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1109\/JBHI.2017.2751509","article-title":"Bayesian optimization of personalized models for patient vital-sign monitoring","volume":"22","author":"G W Colopy","year":"2018","journal-title":"IEEE J Biomed Health Inform"},{"key":"ref24","doi-asserted-by":"crossref","first-page":"3000114","DOI":"10.1109\/JTEHM.2018.2812162","article-title":"Clinician-driven design of VitalPAD-an intelligent monitoring and communication device to improve patient safety in the intensive care unit","volume":"6","author":"L Flohr","year":"2018","journal-title":"IEEE J Transl Eng Health Med"},{"issue":"09","key":"ref25","doi-asserted-by":"crossref","first-page":"e19774","DOI":"10.2196\/19774","article-title":"Integrating and evaluating the data quality and utility of smart pump information in detecting medication administration errors: evaluation study","volume":"8","author":"Y Ni","year":"2020","journal-title":"JMIR Med Inform"},{"key":"ref26","doi-asserted-by":"crossref","first-page":"7803","DOI":"10.1109\/ACCESS.2018.2886879","article-title":"Neo-bedside monitoring device for integrated neonatal intensive care unit (iNICU)","volume":"7","author":"H Singh","year":"2019","journal-title":"IEEE Access"},{"issue":"07","key":"ref27","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1007\/s40264-015-0303-y","article-title":"Preventability of voluntarily reported or trigger tool-identified medication errors in a pediatric institution by information technology: a retrospective cohort study","volume":"38","author":"J S Stultz","year":"2015","journal-title":"Drug Saf"},{"issue":"11","key":"ref28","doi-asserted-by":"crossref","first-page":"e191","DOI":"10.2196\/mhealth.9676","article-title":"Experience of emergency department patients with using the talking pole device: prospective interventional descriptive study","volume":"6","author":"J Yoo","year":"2018","journal-title":"JMIR Mhealth Uhealth"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1186\/1472-6823-14-62","article-title":"Glucose control in intensive care: usability, efficacy and safety of Space GlucoseControl in two medical European intensive care units","volume":"14","author":"K Amrein","year":"2014","journal-title":"BMC Endocr Disord"},{"issue":"01","key":"ref30","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1109\/TBCAS.2011.2157822","article-title":"Onboard tagging for real-time quality assessment of photoplethysmograms acquired by a wireless reflectance pulse oximeter","volume":"6","author":"K Li","year":"2012","journal-title":"IEEE Trans Biomed Circuits Syst"},{"key":"ref31","first-page":"3200109","article-title":"Integration of new technology for research in the emergency department: feasibility of deploying a robotic assessment tool for mild traumatic brain injury evaluation","volume":"3","author":"V Subbian","year":"2015","journal-title":"IEEE J Transl Eng Health Med"},{"key":"ref32","doi-asserted-by":"crossref","first-page":"52355","DOI":"10.1109\/ACCESS.2018.2864264","article-title":"A new smart mobile system for chronic wound care management","volume":"6","author":"S Wang","year":"2018","journal-title":"IEEE Access"},{"issue":"02","key":"ref33","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1109\/JBHI.2018.2834863","article-title":"Improving patient safety and clinician workflow in the general care setting with enhanced surveillance monitoring","volume":"23","author":"S P McGrath","year":"2019","journal-title":"IEEE J Biomed Health Inform"},{"issue":"06","key":"ref34","doi-asserted-by":"crossref","first-page":"482","DOI":"10.3414\/ME14-01-0027","article-title":"From adverse drug event detection to prevention. A novel clinical decision support framework for medication safety","volume":"53","author":"V G Koutkias","year":"2014","journal-title":"Methods Inf Med"},{"issue":"04","key":"ref35","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1109\/JBHI.2012.2234130","article-title":"A large-scale clinical validation of an integrated monitoring system in the emergency department","volume":"17","author":"D A Clifton","year":"2013","journal-title":"IEEE J Biomed Health Inform"},{"issue":"03","key":"ref36","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1177\/1932296818798036","article-title":"Development and implementation of a subcutaneous insulin clinical decision support tool for hospitalized patients","volume":"13","author":"N Mathioudakis","year":"2019","journal-title":"J Diabetes Sci Technol"},{"issue":"11","key":"ref37","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1001\/jama.2018.11029","article-title":"Clinical implications and challenges of artificial intelligence and deep learning","volume":"320","author":"W W Stead","year":"2018","journal-title":"JAMA"},{"issue":"03","key":"ref40","doi-asserted-by":"crossref","first-page":"e000202","DOI":"10.1136\/bmjoq-2017-000202","article-title":"Managing alarm systems for quality and safety in the hospital setting","volume":"7","author":"T A Bach","year":"2018","journal-title":"BMJ Open Qual"},{"key":"ref41","volume-title":"Alarm fatigue","author":"W Meghan","year":"2020"},{"key":"ref42","first-page":"41","volume-title":"Errors related to alert fatigue","author":"H van der Sijs","year":"2016"},{"issue":"16","key":"ref44","doi-asserted-by":"crossref","first-page":"1697","DOI":"10.1001\/jama.2016.2402","article-title":"Digital health and patient safety","volume":"315","author":"S O Agboola","year":"2016","journal-title":"JAMA"},{"issue":"06","key":"ref45","doi-asserted-by":"crossref","first-page":"125","DOI":"10.5811\/westjem.2020.7.47832","article-title":"Review of the basics of cognitive error in emergency medicine: still no easy answers","volume":"21","author":"S Hartigan","year":"2020","journal-title":"West J Emerg Med"},{"issue":"03","key":"ref46","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1159\/000502951","article-title":"Metadata concepts for advancing the use of digital health technologies in clinical research","volume":"3","author":"R Badawy","year":"2019","journal-title":"Digit Biomark"},{"issue":"06","key":"ref47","doi-asserted-by":"crossref","first-page":"1242","DOI":"10.1093\/jamia\/ocab006","article-title":"Healthcare process modeling to phenotype clinician behaviors for exploiting the signal gain of clinical expertise (HPM-ExpertSignals): development and evaluation of a conceptual framework","volume":"28","author":"S C Rossetti","year":"2021","journal-title":"J Am Med Inform Assoc"},{"key":"ref48","doi-asserted-by":"crossref","first-page":"103343","DOI":"10.1016\/j.jbi.2019.103343","article-title":"EHR audit logs: a new goldmine for health services research?","volume":"101","author":"J Adler-Milstein","year":"2020","journal-title":"J Biomed Inform"},{"issue":"02","key":"ref49","doi-asserted-by":"crossref","first-page":"94","DOI":"10.7861\/futurehosp.6-2-94","article-title":"The potential for artificial intelligence in healthcare","volume":"6","author":"T Davenport","year":"2019","journal-title":"Future Healthc J"},{"issue":"06","key":"ref50","doi-asserted-by":"crossref","first-page":"e15154","DOI":"10.2196\/15154","article-title":"Artificial intelligence and human trust in healthcare: focus on clinicians","volume":"22","author":"O Asan","year":"2020","journal-title":"J Med Internet Res"},{"issue":"04","key":"ref51","doi-asserted-by":"crossref","first-page":"251","DOI":"10.2471\/BLT.19.237487","article-title":"Artificial intelligence in health care: accountability and safety","volume":"98","author":"I Habli","year":"2020","journal-title":"Bull World Health Organ"},{"key":"ref52","doi-asserted-by":"crossref","first-page":"m689","DOI":"10.1136\/bmj.m689","article-title":"Artificial intelligence versus clinicians: systematic review of design, reporting standards, and claims of deep learning studies","volume":"368","author":"M Nagendran","year":"2020","journal-title":"BMJ"},{"issue":"02","key":"ref53","doi-asserted-by":"crossref","first-page":"1225","DOI":"10.1177\/1460458219874641","article-title":"Exploring healthcare professionals' understanding and experiences of artificial intelligence technology use in the delivery of healthcare: an integrative review","volume":"26","author":"L Shinners","year":"2020","journal-title":"Health Informatics J"},{"issue":"01","key":"ref54","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1080\/1364557032000119616","article-title":"Scoping studies: towards a methodological framework","volume":"8","author":"H Arksey","year":"2005","journal-title":"Int J Soc Res Methodol"},{"key":"ref55","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1016\/j.jclinepi.2020.10.009","article-title":"Conducting high quality scoping reviews-challenges and solutions","volume":"130","author":"H Khalil","year":"2021","journal-title":"J Clin Epidemiol"},{"issue":"04","key":"ref56","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1002\/jrsm.1123","article-title":"A scoping review of scoping reviews: advancing the approach and enhancing the consistency","volume":"5","author":"M T Pham","year":"2014","journal-title":"Res Synth Methods"},{"key":"ref57","first-page":"305","article-title":"Cyber security vulnerabilities in medical devices: a complex environment and multifaceted problem","volume":"8","author":"P A Williams","year":"2015","journal-title":"Med Devices (Auckl)"}],"container-title":["Applied Clinical 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