Table 3 Summary of patient safety outcomes, patient safety outcome measures, and processes of care in included studies

Incidence of Pressure ulcers

Armstrong, 2023

Frequency of hospital-acquired pressure injuries (HAPIs) development

HAPIs assessing tools

Standardised reporting system via the electronic health information record system used to detect and o monitor HAPIs for ICU patients

Behrendt et al., 2014.

Frequency of stage II pressure ulcer development

HAPIs staging tool

Intervention group: Pressure Ulcer Systems (CBPM) informed repositioning of patients to off-load high pressure areas.

Control group: patients repositioned based on protocol.

Incidence of medication errors

Chapuis et al., 2010.

Frequency of medication errors.

Audit tool to identify picking, preparation, and administration related medication errors

Intervention group: Medication Administration Systems (ADDS) used to prepare, dispense and administer medications.

Control group: classic medication cabinet used to prepare, dispense and administer medications.

Glucose control in critical care settings

Ang et al., 2024

Time spent within targeted blood glucose range

Blood glucose levels via CGM devices compared with point-of-care blood glucose levels

Audit tool capturing time patients spent in target range

Audit tool capturing glucose levels Blood glucose levels

CGM device used to monitor glucose levels for postoperative patients with hyperglycemia and requiring intravenous insulin infusions in ICUs

Mann et al., 2011.

Time spent within normal blood glucose range;

Rates of hypoglycaemia.

Audit tool capturing time patients spent in target normoglycaemic range;

Audit tool capturing incidence of hypoglycaemia.

Intervention group: CDSSs used to send alert messages to nurses to facilitate regular blood glucose management and insulin therapy.

Control group: standard care protocol used to facilitate regular blood glucose measurements and appropriate managements.

Meyfroidt et al., 2011.

Mean blood glucose level in normal range;

Incidence of GPI and HGI and episodes of hypoglycaemia.

Audit tool capturing mean blood glucose levels;

Audit tool capturing Glycaemic penalty index (GPI);

Audit tool capturing Hyperglycaemic index (HGI);

Audit tool capturing episodes of hypoglycaemia.

CDSSs used to send alert messages to nurses to facilitate regular blood glucose measurements and appropriate management.

Compliance with care bundles in Intensive Care Units

Kahn et al., 2014.

Nursing staff compliance with ICU care bundle;

Audit tools to measuring the compliance rates with ventilator care bundles;

Nurse-led EHR model used to support nurses to adhere to evidence-based practice and provide regular ventilator bundle care

Zhang et al., 2024

Percentage of inaccurate vital signs documentations;

Percentage of missed medication administrations;

Percentage of incomplete nursing assessments

Medical records capturing the number of inaccurate vital signs, missed medication administrations and incomplete nursing assessment documentations

CDSSs working as quality control purpose used to send alerts to nurses to identify any inaccurate vital signs, missed medication administrations and incomplete mandatory nursing assessments

Incidence of ICU-acquired complications.

Kahn et al., 2014.

Ventilator-associated pneumonia rates;

Audit tools capturing incidence of ventilator-associated pneumonia rates;

Nurse-led EHR model used to support nurses to adhere to evidence-based practice and provide regular ventilator bundle care

Ruesch et al., 2012.

Nursing staff compliance with VAP bundles, the deep vein thrombosis and peptic ulcer diseases bundles;

Incidence of ventilator-associated pneumonia;

Audit tool capturing nursing compliance with ventilator-associated pneumonia bundles, deep vein thrombosis bundles and peptic ulcer disease bundles;

Audit tool capturing rates of ventilator-associated pneumonia;

tele-ICU staffing models used to prompt nurses to adhere to evidence-based practice.

Compliance with screening for risks in Emergency Departments

Curtis et al., 2020

Compliance with risk assessments in EDs.

Completion rates of risk assessments (falls, pressure ulcers and substance use) in EDs.

Electronic health information record system used to prompt nurses to complete risk assessments.

Legambi et al., 2021

Compliance with risk assessments for agitation in EDs

Completion rates of the behavioural activity rating scale (BARS)

The electronic health information record system used to facilitate the completion of risk assessments for agitation

Lowenstein et al., 2023

Compliance with risk assessments for opioid misuse in EDs

Completion rates of the clinical opioid withdrawal scale (COWS) assessments

Electronic health information record system and CDSSs used to improve the completion rates of risk assessments for patients with opioid use disorders

Triage accuracy and interrater reliability

McLeod et al., 2020.

Triage interrater reliability.

Audit tool capturing Triage interrater reliability

eCTAS used to inform triage decisions

Meer et al., 2012.

Triage interrater reliability.

Audit tool capturing triage interrater reliability

telehealth used to inform triage decisions

Safety of triage redirection process

Feral-Pierssens et al., 2022

Safety of the redirection process

Medical records capturing the number of patients returned back to EDs unexpectedly within 48 h and within 7 days post redirection process

CDSS used for redirection process in triage for low-acuity patients in EDs

Length of stay and re-admission rates in critical care settings and hospitals

Levesque et al., 2015.

Length of ICU and hospital stay ;

ICU & hospital readmission rates;

Medical record capturing ICU & hospital length of stay;

Audit tool capturing ICU readmission rates ;

Electronic health information record system used to improve the information processing and workflow in ICUs

Kahn et al., 2014.

length of ICU and hospital stay;

Medical record capturing ICU & hospital length of stay

Nurse-led EHR model used to support nurses to adhere to evidence-based practice and provide regular ventilator bundle care

Ruesch et al., 2012.

ICU length of stay;

Medical record capturing ICU length of stay

tele-ICU staffing models used to prompt nurses to adhere to evidence-based practice.

Zikos et al., 2014.

length of ED stay.

Medical record capturing ED length of stay

electronic health information record system used to improve information processing and workflow.

Mortality rates in critical care settings

Levesque et al., 2015.

ICU mortality rate.

Audit tool capturing ICU mortality rate

Electronic health information record system used to improve the information processing and workflow in ICUs

Ruesch et al., 2012.

ICU mortality rate.

Audit tool capturing ICU mortality rate.

tele-ICU staffing models used to prompt nurses to adhere to evidence-based practice.