Understanding the impact of nurses' perception and technological capability on nurses' satisfaction with nursing information system usage: A holistic perspective of alignment

Influence of Supervisors’ Fairness on Work Climate, Job Satisfaction, Task Performance, and Helping Behavior of Health Workers During COVID-19 Outbreak

The need for supervisors to exhibit fairness was a key motivating tool for effective health service delivery during the initial stages of the COVID-19 outbreak. Nonetheless, the number of deaths and hospitalization was alarming health workers were actively working throughout the time. This study explores the role of supervisors’ fairness in creating a work climate and job satisfaction that promote workers’ task performance and helping behaviors. The researchers adopted a quantitative method with a questionnaire used for data collection. SPSS and AMOS were used for data analysis, and statistical models of correlation and hierarchical regression were used to examine relationships among the variables. The study established that supervisors’ fairness has a positive effect on work climate, job satisfaction, task performance, and helping behavior of health workers. Work climate has positive effects of task performance and helping behaviors, whereas job satisfaction also has positive effects on employees’ task performance and helping behavior. The researchers recommended the need for supervisors to exhibit fairness to workers at all times and create room for the workers to appeal their decision to avoid the feeling of supervisors’ biasness.

Nurses' Experience and Perception of Technology Use in Practice: A Qualitative Study Using an Extended Technology Acceptance Model

The purposes of this study are to provide insight into the factors identified as benefits and drawbacks of technology use by nurses and obtain suggestions on improving technology, based on challenges identified to improve patient outcomes. Holden's extended technology acceptance model was used to describe nurses' perception of technology use in practice. A descriptive design and thematic analysis were used to evaluate participants' logged reflections of their experiences and suggestions for improvements of health information technology. Findings indicate that nurses' experiences and perceptions regarding the use of various types of technology (electronic health records, large databases, crowdsourcing, bio-surveillance) were positive. New subdomains emerged for job performance and efficiency, usefulness for public health, contribution to nursing science, and better communication. Identified challenges were insufficient training and support, lack of interoperability, risk of low-quality care from reliance on technology, increased cost, glitches, and alarm fatigue. Understanding nurses' perceptions of technology is anticipated to enhance care quality and possibly lead to improved outcomes. Nurses' perceptions of the use and acceptance of technology are important as their view is associated with performance and may directly influence clinical outcomes and patient satisfaction. Thematic findings include recommendations from participants to improve patient outcomes and patient care.

Nurses

ObjectiveThe aim of this study was to describe nurses' and midwives' experiences following the first phase of the implementation of an electronic medical record (EMR) system at a large public health service in metropolitan Melbourne, Australia.MethodsFour focus groups were held 8-10 months after implementation of the EMR. Transcripts were analysed using thematic analysis.ResultsOf 39 participants, 25 were nurses (64%), 12 were midwives (31%) and two did not provide this information. The mean (±s.d.) duration of clinical experience was 15.6±12.2 years (range 2-40 years). Three main themes were identified: (1) effects on workflow: although some participants reported that EMR facilitated easier access to real-time patient data, others indicated that workflow was disrupted by the EMR being slow and difficult to navigate, system outages and lack of interoperability between the EMR and other systems; (2) effects on patient care and communication: some participants reported that the EMR improved their communication with patients and reduced medication errors, whereas others reported a negative effect on patient care and communication; and (3) negative effects of the EMR on nurses' and midwives' personal well-being, including frustration, stress and exhaustion. These experiences were often reported in the context of cognitive workload due to having to use multiple systems simultaneously or extra work associated with EMR outages.ConclusionNurses' and midwives' experiences of the EMR were complex and mixed. Nurses and midwives require significant training and ongoing technical support in the first 12 months after implementation of an EMR system. Including nurses and midwives in the design and refinement of the EMR will ensure that the EMR aligns with their workflow.What is known about the topic?Studies reporting nurses' and midwives' experiences of using EMR are scarce and mostly based in countries where whole-of-service implementations are carried out, funded by governments.What does this paper add?Nurses and midwives perceive benefits of using an EMR relatively soon after implementation in terms of their workflow and patient care. However, in the first year after EMR implementation, nurses and midwives experience some negative effects on workflow, patient care and their own well-being. The effects on clinical workflow are further compounded by EMR downtime (scheduled and unscheduled) and hybrid systems that require users to access other technology systems alongside the EMR.What are the implications for practitioners?In countries like Australia, whole-of-service, simultaneous implementation of EMR systems using best-available server technology may not be possible due to funding constraints. In these circumstances, nurses and midwives may initially experience increased workload and frustration. Ongoing training and technical support should be provided to nurses and midwives for several months following implementation. Including nurses and midwives in the design of the EMR will result in better alignment with their specific workflow, thus maximising benefits of EMR implementation.

A Tool to Measure Nurses' Perceptions of Electronic Documentation: Exploratory Factor Analysis

BACKGROUND AND PURPOSE

Electronic Health Records (EHRs) have been widely adopted in US hospitals. EHRs have changed workflow and time allocation and have broad impacts on staff. We adapted an existing instrument to measure nurses' perceptions of a newly adopted EHR.

METHODS

The 11-item survey was administered to approximately 500 registered nurses in a mid-sized regional hospital in western US, with 153 responses received. Exploratory factor analysis (EFA) assessed the factor structure and Cronbach's α estimated internal consistency.

RESULTS

A 3-factor model was retained through the EFA, and items were internally consistent (Cronbach's alpha for each subscale > .80).

CONCLUSIONS

Survey adaptation was iterative and resulted in a psychometrically sound and thematically relevant measure of nurses' EHR perceptions. Next steps include further psychometric evaluation and testing with additional samples.

Nurses' use of mobile instant messaging applications: A uses and gratifications perspective

AIM

To explore how and why mobile instant messaging applications are used by Filipino nurses as part of their work.

METHODS

Guided by the uses and gratifications theory, in-depth interviews with 20 staff nurses working in 9 hospitals (ie, 4 private and 5 public hospitals) in the Philippines were conducted in July 2015. Interview data were analysed through a phenomenological perspective to thematic analysis.

RESULTS

Results show that mobile instant messaging applications such as Facebook Messenger and Viber were mostly used by staff nurses and these were accessed using their own smartphones. Thematic analysis indicates that they were used to meet staff nurses' need for information exchange, socialization, and catharsis. Moreover, user interactions vary depending on members within a chat group. For instance, communication via mobile instant messaging applications are much formal when superiors are included in a chat group.

CONCLUSION

In general, the results show that mobile instant messaging applications are routinely used by Filipino staff nurses not only for clinical purposes (ie, information exchange) but also for non-clinical purposes (ie, socialization and catharsis). This paper ends with several practical and theoretical implications including future research directions.