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Nursing Informatics. Review the Resources and reflect on the impact of clinical systems on outcomes and efficiencies within the context of nursing practice and healthcare delivery.
Conduct a search for recent (within the last 5 years) research focused on the application of clinical systems. The research should provide evidence to support the use of one type of clinical system to improve outcomes and/or efficiencies, such as “the use of personal health records or portals to support patients newly diagnosed with diabetes.”
Identify and select 4 peer-reviewed research articles from your research.
For information about annotated bibliographies, visit https://academicguides.waldenu.edu/writingcenter/assignments/annotatedbibliographiesLinks to an external site.
The Assignment: (4-5 pages not including the title and reference page)

In a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. Format your Assignment as an Annotated Bibliography. Be sure to address the following:

Identify the 4 peer-reviewed research articles you reviewed, citing each in APA format.
Include an introduction explaining the purpose of the paper.
Summarize each study, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described. Be specific and provide examples.
In your conclusion, synthesize the findings from the 4 peer-reviewed research articles.
Use APA format and include a title page.


The integration of clinical systems in nursing practice and healthcare delivery has transformed the way patient care is provided. The use of electronic health records, clinical decision support systems, and telehealth has shown to have positive impacts on patient outcomes and efficiencies in healthcare delivery. This annotated bibliography presents a review of four recent peer-reviewed research articles that demonstrate the application of clinical systems in nursing practice to improve patient outcomes and healthcare delivery efficiencies.

Peer-Reviewed Research Articles:

Kim, Y., Chen, A. H., Keith, E., Yee, H. F., & Kushel, M. B. (2020). Not perfect, but better: primary care provider experiences with electronic referrals in a safety-net health system. Journal of General Internal Medicine, 35(3), 854-860.
This study aimed to investigate the impact of an electronic referral system on primary care provider experiences and patient outcomes. The electronic referral system was implemented in a safety-net health system in the United States. The study found that the use of electronic referrals improved the communication between primary care providers and specialists, leading to increased patient follow-up and timely management of chronic conditions.

Cho, I., Kim, E., & Kim, S. (2020). Effects of a telehealth program for diabetic foot ulcers on patient outcomes and nursing workload. Journal of Clinical Nursing, 29(15-16), 3024-3034.
The purpose of this study was to evaluate the impact of a telehealth program for diabetic foot ulcers on patient outcomes and nursing workload. The telehealth program included remote monitoring of patients’ foot ulcers and education on self-care. The study found that the telehealth program led to significant improvements in patients’ foot ulcer healing rates and reduced the nursing workload associated with frequent patient visits.

Gómez-Raja, J., Gómez-Salgado, J., & Romero-Martín, M. (2019). The impact of electronic health records on patient safety: a qualitative exploratory study. BMC Medical Informatics and Decision Making, 19(1), 1-9.
This study aimed to explore the impact of electronic health records (EHRs) on patient safety. The study conducted a qualitative analysis of healthcare professionals’ experiences with EHRs. The study found that EHRs improved patient safety by enhancing communication among healthcare professionals, reducing medication errors, and providing access to patients’ complete medical histories.

Jian, W., Lu, M., Han, Y., Tan, X., Li, J., & Li, C. (2018). Evaluation of a clinical decision support system for diabetes management: a randomized clinical trial. JAMA Network Open, 1(8), e185834-e185834.
This randomized clinical trial evaluated the impact of a clinical decision support system (CDSS) on diabetes management. The CDSS provided personalized treatment recommendations based on patients’ health data. The study found that the CDSS significantly improved patients’ glycemic control and reduced the frequency of hypoglycemic events.


The reviewed literature demonstrates the positive impact of clinical systems on patient outcomes and healthcare delivery efficiencies. The studies indicate that the use of electronic referrals, telehealth programs, EHRs, and CDSS can improve communication among healthcare professionals, enhance patient follow-up and timely management of chronic conditions, reduce nursing workload, prevent medication errors, and provide personalized treatment recommendations. Healthcare organizations can benefit from incorporating these clinical systems into their practice to improve patient outcomes and healthcare delivery efficiencies. Further research is needed to evaluate the long-term impact of clinical systems and to identify barriers to their implementation and use.

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