1
|
Huang FT. Caring for Computers: The Hidden Work of Clinical Nurses during the Introduction of Health Information Systems in a Teaching Hospital in Taiwan. NURSING REPORTS 2021; 11:105-119. [PMID: 34968317 PMCID: PMC8608098 DOI: 10.3390/nursrep11010011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 02/09/2021] [Accepted: 02/10/2021] [Indexed: 12/02/2022] Open
Abstract
Implementing health information systems for enhancing patient care and management occurs worldwide. Discovering how nurses, as important system end-users, experience technology-reliant clinical practice involved focus groups (n = 25) and in-depth individual interviews with nurses (n = 4) and informatics staff (n = 3) in a major Taiwanese medical center. This qualitative study explores the unintended effects of these systems on nurses’ role and clinical practice. First, nurses’ additional role caring for computer devices supporting patient care involves highly-demanding invisible effort, especially when tackling system malfunctions affecting patients with urgent conditions. Second, nurses are resourceful in developing solutions to protect patients during unexpected technical malfunctions. Third, troubleshooting using telephone technical support as the first resort is problematic. It is argued that computerization requires nurses to care for co-clients: patients and computers. Managing technical malfunctions is an unintended consequence for nurses, reflecting the hidden work required by new technology.
Collapse
Affiliation(s)
- Feng-Tzu Huang
- Liberal Arts Center, Department of Nursing, Da-Yeh University, Changhua 51591, Taiwan
| |
Collapse
|
2
|
Zhou Y, Li Z, Li Y. Interdisciplinary collaboration between nursing and engineering in health care: A scoping review. Int J Nurs Stud 2021; 117:103900. [PMID: 33677250 DOI: 10.1016/j.ijnurstu.2021.103900] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 01/29/2021] [Accepted: 01/31/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Due to the rapid advancements in precision medicine and artificial intelligence, interdisciplinary collaborations between nursing and engineering have emerged. Although engineering is vital in solving complex nursing problems and advancing healthcare, the collaboration between the two fields has not been fully elucidated. OBJECTIVES To identify the study areas of interdisciplinary collaboration between nursing and engineering in health care, particularly focusing on the role of nurses in the collaboration. METHODS In this study, a scoping review using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews was performed. A comprehensive search for published literature was conducted using the PubMed, Cumulative Index to Nursing and Allied Health Literature, Scopus, Embase, Web of Science, ScienceDirect, Institute of Electrical and Electronics Engineers Digital Library, and Association for Computing Machinery Digital Library from inception to November 22, 2020. Data screening and extraction were performed independently by two reviewers. Any discrepancies in results were resolved through discussions or in consultation with a third reviewer. Data were analyzed by descriptive statistics and content analysis. Results were visualized in an interdisciplinary collaboration model. RESULTS We identified 6,752 studies through the literature search, and 60 studies met the inclusion criteria. The study areas of interdisciplinary collaboration concentrated on patient safety (n = 18), symptom monitoring and health management (n = 18), information system and nursing human resource management (n = 16), health education (n = 5), and nurse-patient communication (n = 3). The roles of nurses in the interdisciplinary collaboration were divided into four themes: requirement analyst (n = 21), designer (n = 22), tester(n = 37) and evaluator (n = 49). Based on these results, an interdisciplinary collaboration model was constructed. CONCLUSIONS Interdisciplinary collaborations between nursing and engineering promote nursing innovation and practice. However, these collaborations are still emerging and in the early stages. In the future, nurses should be more involved in the early stages of solving healthcare problems, particularly in the requirement analysis and designing phases. Furthermore, there is an urgent need to develop interprofessional education, strengthen nursing connections with the healthcare engineering industry, and provide more platforms and resources to bring nursing and engineering disciplines together.
Collapse
Affiliation(s)
- Ying Zhou
- School of Nursing, Chinese Academy of Medical Sciences and Peking Union Medical College, No 33 Ba Da Chu Road, Shijingshan District, Beijing 100144, China.
| | - Zheng Li
- School of Nursing, Chinese Academy of Medical Sciences and Peking Union Medical College, No 33 Ba Da Chu Road, Shijingshan District, Beijing 100144, China.
| | - Yingxin Li
- Institute of Biomedical Engineering, Chinese Academy of Medical Sciences and Peking Union Medical College, No 236 Bai Di Lu Road, Nankai District, Tianjin 300192, China.
| |
Collapse
|
3
|
Lee J, Kang MJ, Garcia JP, Dykes PC. Developing hierarchical standardized home care nursing statements using nursing standard terminologies. Int J Med Inform 2020; 141:104227. [DOI: 10.1016/j.ijmedinf.2020.104227] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 05/15/2020] [Accepted: 06/26/2020] [Indexed: 11/29/2022]
|
4
|
Markazi-Moghaddam N, Kazemi A, Alimoradnori M. Using the importance-performance analysis to improve hospital information system attributes based on nurses’ perceptions. INFORMATICS IN MEDICINE UNLOCKED 2019. [DOI: 10.1016/j.imu.2019.100251] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
|
5
|
Setyohadi DB, Purnawati NW. An investigation of external factors for technological acceptance model of nurses in Indonesia. ACTA ACUST UNITED AC 2018. [DOI: 10.1088/1757-899x/403/1/012064] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
6
|
Stifter J, Sousa VEC, Febretti A, Dunn Lopez K, Johnson A, Yao Y, Keenan GM, Wilkie DJ. Acceptability of Clinical Decision Support Interface Prototypes for a Nursing Electronic Health Record to Facilitate Supportive Care Outcomes. Int J Nurs Knowl 2018; 29:242-252. [PMID: 28926204 PMCID: PMC5858953 DOI: 10.1111/2047-3095.12178] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 04/13/2017] [Accepted: 04/19/2017] [Indexed: 11/29/2022]
Abstract
PURPOSE To determine the acceptability, usefulness, and ease of use for four nursing clinical decision support interface prototypes. METHODS In a simulated hospital environment, 60 registered nurses (48 female; mean age = 33.7 ± 10.8; mean years of experience = 8.1 ± 9.7) participated in a randomized study with four study groups. Measures included acceptability, usefulness, and ease of use scales. FINDINGS Mean scores were high for acceptability, usefulness, and the ease of use for all four groups. Inexperienced participants (<1 year) reported higher perceived ease of use (p = .05) and perceived usefulness (p = .01) than those with experience of 1 year or more. CONCLUSIONS Participants completed the protocol and reported that all four interfaces, including the control (HANDS), were acceptable, easy to use, and useful. IMPLICATIONS FOR NURSING KNOWLEDGE Further study is warranted before clinical implementation within the electronic health record.
Collapse
Affiliation(s)
| | | | | | | | - Andrew Johnson
- Associate Professor and Director of Research at the Electronic Visualization Laboratory, Department of Computer Science, College of Engineering
| | - Yingwei Yao
- Research Associate Professor at the College of Nursing, University of Illinois at Chicago, Chicago, Illinois, and at the College of Nursing, University of Florida, Gainesville, Florida
| | - Gail M Keenan
- Adjunct Professor at the College of Nursing, University of Illinois at Chicago, Chicago, Illinois, and the Annabel Davis Jenks Endowed Professor for Teaching and Research in Nursing Clinical Excellence at the College of Nursing, University of Florida, Gainesville, Florida
| | - Diana J Wilkie
- Adjunct Professor at the College of Nursing, University of Illinois at Chicago, Chicago, Illinois, and Professor at Prairieview Trust - Earl and Margo Powers Endowed Professor, and Director of the Academic Center of Excellence in Palliative Care Research and Education, College of Nursing, University of Florida, Gainesville, Florida
| |
Collapse
|
7
|
Samadbeik M, Shahrokhi N, Saremian M, Garavand A, Birjandi M. Information Processing in Nursing Information Systems: An Evaluation Study from a Developing Country. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2017; 22:377-382. [PMID: 29033993 PMCID: PMC5637147 DOI: 10.4103/ijnmr.ijnmr_201_16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
BACKGROUND In recent years, information technology has been introduced in the nursing departments of many hospitals to support their daily tasks. Nurses are the largest end user group in Hospital Information Systems (HISs). This study was designed to evaluate data processing in the Nursing Information Systems (NISs) utilized in many university hospitals in Iran. METHODS AND MATERIALS This was a cross-sectional study. The population comprised all nurse managers and NIS users of the five training hospitals in Khorramabad city (N = 71). The nursing subset of HIS-Monitor questionnaire was used to collect the data. Data were analyzed by the descriptive-analytical method and the inductive content analysis. RESULTS The results indicated that the nurses participating in the study did not take a desirable advantage of paper (2.02) and computerized (2.34) information processing tools to perform nursing tasks. Moreover, the less work experience nurses have, the further they utilize computer tools for processing patient discharge information. The "readability of patient information" and "repetitive and time-consuming documentation" were stated as the most important expectations and problems regarding the HIS by the participating nurses, respectively. CONCLUSIONS The nurses participating in the present study used to utilize paper and computerized information processing tools together to perform nursing practices. Therefore, it is recommended that the nursing process redesign coincides with NIS implementation in the health care centers.
Collapse
Affiliation(s)
- Mahnaz Samadbeik
- Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Nafiseh Shahrokhi
- Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Marzieh Saremian
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Ali Garavand
- School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahdi Birjandi
- Department of Statistics and Epidemiology, School of Health and Nutrition, Lorestan University of Medical Sciences, Khorramabad, Iran
| |
Collapse
|
8
|
Sousa VEC, Dunn Lopez K. Towards Usable E-Health. A Systematic Review of Usability Questionnaires. Appl Clin Inform 2017; 8:470-490. [PMID: 28487932 PMCID: PMC6241759 DOI: 10.4338/aci-2016-10-r-0170] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 02/26/2017] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The use of e-health can lead to several positive outcomes. However, the potential for e-health to improve healthcare is partially dependent on its ease of use. In order to determine the usability for any technology, rigorously developed and appropriate measures must be chosen. OBJECTIVES To identify psychometrically tested questionnaires that measure usability of e-health tools, and to appraise their generalizability, attributes coverage, and quality. METHODS We conducted a systematic review of studies that measured usability of e-health tools using four databases (Scopus, PubMed, CINAHL, and HAPI). Non-primary research, studies that did not report measures, studies with children or people with cognitive limitations, and studies about assistive devices or medical equipment were systematically excluded. Two authors independently extracted information including: questionnaire name, number of questions, scoring method, item generation, and psychometrics using a data extraction tool with pre-established categories and a quality appraisal scoring table. RESULTS Using a broad search strategy, 5,558 potentially relevant papers were identified. After removing duplicates and applying exclusion criteria, 35 articles remained that used 15 unique questionnaires. From the 15 questionnaires, only 5 were general enough to be used across studies. Usability attributes covered by the questionnaires were: learnability (15), efficiency (12), and satisfaction (11). Memorability (1) was the least covered attribute. Quality appraisal showed that face/content (14) and construct (7) validity were the most frequent types of validity assessed. All questionnaires reported reliability measurement. Some questionnaires scored low in the quality appraisal for the following reasons: limited validity testing (7), small sample size (3), no reporting of user centeredness (9) or feasibility estimates of time, effort, and expense (7). CONCLUSIONS Existing questionnaires provide a foundation for research on e-health usability. However, future research is needed to broaden the coverage of the usability attributes and psychometric properties of the available questionnaires.
Collapse
Affiliation(s)
- Vanessa E C Sousa
- Vanessa E. C. Sousa, PhD, MSN, University of Illinois at Chicago, College of Nursing, Department of Health Systems Science, 845 South Damen St., Chicago, IL 60612, , Phone: 773-814-0517
| | | |
Collapse
|
9
|
Ellsworth MA, Dziadzko M, O'Horo JC, Farrell AM, Zhang J, Herasevich V. An appraisal of published usability evaluations of electronic health records via systematic review. J Am Med Inform Assoc 2017; 24:218-226. [PMID: 27107451 PMCID: PMC7654077 DOI: 10.1093/jamia/ocw046] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2015] [Revised: 02/25/2016] [Accepted: 03/01/2016] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE In this systematic review, we aimed to evaluate methodological and reporting trends present in the current literature by investigating published usability studies of electronic health records (EHRs). METHODS A literature search was conducted for articles published through January 2015 using MEDLINE (Ovid), EMBASE, Scopus, and Web of Science, supplemented by citation and reference list reviews. Studies were included if they tested the usability of hospital and clinic EHR systems in the inpatient, outpatient, emergency department, or operating room setting. RESULTS A total of 4848 references were identified for title and abstract screening. Full text screening was performed for 197 articles, with 120 meeting the criteria for study inclusion. CONCLUSION A review of the literature demonstrates a paucity of quality published studies describing scientifically valid and reproducible usability evaluations at various stages of EHR system development. A lack of formal and standardized reporting of EHR usability evaluation results is a major contributor to this knowledge gap, and efforts to improve this deficiency will be one step of moving the field of usability engineering forward.
Collapse
Affiliation(s)
- Marc A Ellsworth
- Division of Neonatal Medicine, Mayo Clinic, Rochester, MN, USA
- Multidisciplinary Epidemiology and Translational Research in Critical Care, Emergency and Perioperative Medicine (METRIC-PM) Group, Mayo Clinic, Rochester, MN, USA
| | - Mikhail Dziadzko
- Multidisciplinary Epidemiology and Translational Research in Critical Care, Emergency and Perioperative Medicine (METRIC-PM) Group, Mayo Clinic, Rochester, MN, USA
- Department of Anesthesiology, Mayo Clinic, Rochester, MN, USA
| | - John C O'Horo
- Multidisciplinary Epidemiology and Translational Research in Critical Care, Emergency and Perioperative Medicine (METRIC-PM) Group, Mayo Clinic, Rochester, MN, USA
- Division of Infectious Diseases, Mayo Clinic, Rochester, MN, USA
| | - Ann M Farrell
- Mayo Clinic Libraries, Mayo Clinic, Rochester, MN, USA
| | - Jiajie Zhang
- School of Health Information Sciences, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Vitaly Herasevich
- Multidisciplinary Epidemiology and Translational Research in Critical Care, Emergency and Perioperative Medicine (METRIC-PM) Group, Mayo Clinic, Rochester, MN, USA
- Department of Anesthesiology, Mayo Clinic, Rochester, MN, USA
| |
Collapse
|
10
|
Abstract
The electronic health record is a key component of healthcare information systems. Currently, numerous hospitals have adopted electronic health records to replace paper-based records to document care processes and improve care quality. Integrating healthcare information system into traditional nursing daily operations requires time and effort for nurses to become familiarized with this new technology. In the stages of electronic health record implementation, smooth adoption can streamline clinical nursing activities. In order to explore the adoption process, a descriptive qualitative study design and focus group interviews were conducted 3 months after and 2 years after electronic health record system implementation (system aborted 1 year in between) in one hospital located in southern Taiwan. Content analysis was performed to analyze the interview data, and six main themes were derived, in the first stage: (1) liability, work stress, and anticipation for electronic health record; (2) slow network speed, user-unfriendly design for learning process; (3) insufficient information technology/organization support; on the second stage: (4) getting used to electronic health record and further system requirements, (5) benefits of electronic health record in time saving and documentation, (6) unrealistic information technology competence expectation and future use. It concluded that user-friendly design and support by informatics technology and manpower backup would facilitate this adoption process as well.
Collapse
|
11
|
Understanding the impact of nurses' perception and technological capability on nurses' satisfaction with nursing information system usage: A holistic perspective of alignment. COMPUTERS IN HUMAN BEHAVIOR 2016. [DOI: 10.1016/j.chb.2015.12.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
12
|
Shah MH, Peikari HR. Electronic Prescribing Usability: Reduction of Mental Workload and Prescribing Errors Among Community Physicians. Telemed J E Health 2016; 22:36-44. [DOI: 10.1089/tmj.2014.0246] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Mahmood Hussain Shah
- Lancashire Business School, University of Central Lancashire, Preston, United Kingdom
| | - Hamid Reza Peikari
- Department of Management, Ragheb Isfahani Higher Education Institute, Esfahan, Iran
| |
Collapse
|
13
|
Cohen JF, Coleman E, Kangethe MJ. An importance-performance analysis of hospital information system attributes: A nurses' perspective. Int J Med Inform 2015; 86:82-90. [PMID: 26564330 DOI: 10.1016/j.ijmedinf.2015.10.010] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Revised: 10/25/2015] [Accepted: 10/31/2015] [Indexed: 11/29/2022]
Abstract
PURPOSE Health workers have numerous concerns about hospital IS (HIS) usage. Addressing these concerns requires understanding the system attributes most important to their satisfaction and productivity. Following a recent HIS implementation, our objective was to identify priorities for managerial intervention based on user evaluations of the performance of the HIS attributes as well as the relative importance of these attributes to user satisfaction and productivity outcomes. PROCEDURES We collected data along a set of attributes representing system quality, data quality, information quality, and service quality from 154 nurse users. Their quantitative responses were analysed using the partial least squares approach followed by an importance-performance analysis. Qualitative responses were analysed using thematic analysis to triangulate and supplement the quantitative findings. MAIN FINDINGS Two system quality attributes (responsiveness and ease of learning), one information quality attribute (detail), one service quality attribute (sufficient support), and three data quality attributes (records complete, accurate and never missing) were identified as high priorities for intervention. CONCLUSIONS Our application of importance-performance analysis is unique in HIS evaluation and we have illustrated its utility for identifying those system attributes for which underperformance is not acceptable to users and therefore should be high priorities for intervention.
Collapse
Affiliation(s)
- Jason F Cohen
- University of the Witwatersrand, Johannesburg, South Africa.
| | - Emma Coleman
- University of the Witwatersrand, Johannesburg, South Africa
| | | |
Collapse
|
14
|
Electronic health record use by nurses in mental health settings: a literature review. Arch Psychiatr Nurs 2015; 29:238-41. [PMID: 26165979 DOI: 10.1016/j.apnu.2015.03.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Revised: 03/25/2015] [Accepted: 03/28/2015] [Indexed: 11/22/2022]
Abstract
BACKGROUND Electronic health records are being implemented in mental health clinical environments at an increasingly high rate. The primary clinicians who utilize this technology are nurses and physicians, with nurses constituting the largest user group. Implementing this technology is complex, especially in this unique context. Understanding the previous experiences of mental health nurses who use electronic health records is therefore important as a means of identifying strategies to best implement the technology. OBJECTIVES The purpose of this study is to review the literature on electronic health record use by nurses in mental health clinical settings in order to be able to provide recommendations for how this technology can be most effectively introduced. DESIGN A literature review was conducted. Ovid/MEDLINE®, PubMed, and the Cumulative Index to Nursing and Allied Health Literature were searched utilizing the following key words: " electronic health record", "electronic medical record", "clinical information system", "mental health", "nursing", and "psychiatry". Studies were screened for inclusion and exclusion criteria by two researchers. RESULTS Seven studies were included after duplicates were eliminated, and inclusion/exclusion criteria were applied. CONCLUSIONS The mental health setting is a unique environment in which special attention needs to be given during technology implementation. As mental health nurses may have less experience and comfort using technology in their practice, more and a longer duration of support during implementation may be required. Additional strategies to support successful EHR use are discussed.
Collapse
|
15
|
LIAO PEIHUNG, CHU WILLIAM, CHU WOEICHYN. Evaluation of the Mining Techniques in Constructing a Traditional Chinese-Language Nursing Recording System. Comput Inform Nurs 2014; 32:223-31. [DOI: 10.1097/cin.0000000000000051] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
16
|
O'Mahony D, Wright G, Yogeswaran P, Govere F. Knowledge and attitudes of nurses in community health centres about electronic medical records. Curationis 2014; 37:1150. [PMID: 24832678 DOI: 10.4102/curationis.v37i1.1150] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Revised: 10/12/2013] [Accepted: 10/22/2013] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Nurses in primary healthcare record data for the monitoring and evaluation of diseases and services. Information and communications technology (ICT) can improve quality in healthcare by providing quality medical records. However, worldwide, the majority of health ICT projects have failed. Individual user acceptance is a crucial factor in successful ICT implementation. OBJECTIVES The aim of this study is to explore nurses' knowledge, attitudes and perceptions regarding ICT so as to inform the future implementation of electronic medical record (EMR) systems. METHODS A qualitative design was used. Semi-structured interviews were undertaken with nurses at three community health centres (CHCs) in the King Sabata Dalyindyebo Local Municipality. The interview guide was informed by the literature on user acceptance of ICT. Interviews were recorded and analysed using content analysis. RESULTS Many nurses knew about health ICT and articulated clearly the potential benefits of an EMR such as fewer errors, more complete records, easier reporting and access to information. They thought that an EMR system would solve the challenges they identified with the current paper-based record system, including duplication of data, misfiling, lack of a chronological patient record, excessive time in recording and reduced time for patient care. For personal ICT needs, approximately half used cellphone Internet-based services and computers. CONCLUSIONS In this study, nurses identified many challenges with the current recording methods. They thought that an EMR should be installed at CHCs. Their knowledge about EMR, positive attitudes to ICT and personal use of ICT devices increase the likelihood of successful EMR implementation at CHCs.
Collapse
Affiliation(s)
- Don O'Mahony
- Department of Family Medicine, Walter Sisulu University.
| | | | | | | |
Collapse
|
17
|
Kahouei M, Baba Mohammadi H, Askari Majdabadi H, Solhi M, Parsania Z, Said Roghani P, Firozeh M. Nurses' perceptions of usefulness of nursing information system: module of electronic medical record for patient care in two university hospitals of iran. Mater Sociomed 2014; 26:30-4. [PMID: 24757398 PMCID: PMC3990381 DOI: 10.5455/msm.2014.26.30-34] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2013] [Accepted: 01/25/2014] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION For almost fifteen years, the application of computer in hospitals increasingly has become popular. Nurses' beliefs and attitudes towards computer is one of the most important indicators of the application of nursing information system. The purpose of this study was to investigate the perceptions of nurses on the usefulness of nursing information system for patient care. METHODS Here, a descriptive study was carried out. Sample was consisted of 316 nurses working in teaching hospitals in an urban area of Iran. This study was conducted during 2011 to 2012. A reliable and valid questionnaire was developed as a data collection tool. The collected data was analyzed using descriptive and inferential statistics. RESULTS It was not believed that nursing information system was useful for patient care. However, it was mentioned that nursing information system is useful in some aspects of patient care such as expediting care, making early diagnosis and formulating diet plan. A significant association was found between the demographic background of sample and their perceptions of the usefulness of nursing information system (P<0.05). CONCLUSION Totally, it can be concluded that nursing information system has a potential for improving patient care in hospital settings. Therefore, policy makers should consider implementing nursing information system in teaching hospitals.
Collapse
Affiliation(s)
- Mehdi Kahouei
- Research Center of Social Determinants for Health, Head of Allied Health Department, Nursing and Allied Health Faculty, Semnan University of Medical Sciences, Semnan, Iran
| | - Hassan Baba Mohammadi
- Department of Nursing, Nursing and Allied Health Faculty, Semnan University of Medical Sciences, Semnan, Iran
| | - Hesamedin Askari Majdabadi
- Health Education and Promotion Department, School of Health, Iran University of Medical Sciences, Tehran, Iran ; Health Department, Nursing and Allied health school, Semnan University of Medical Sciences. Semnan, Iran
| | - Mahnaz Solhi
- Health Education and Promotion Department, School of Health, Iran University of Medical Sciences, Tehran, Iran
| | - Zeinab Parsania
- Department of Nursing, Islamic Azad University, Semnan branch, Semnan, Iran
| | - Panoe Said Roghani
- Department of Nursing, Islamic Azad University, Semnan branch, Semnan, Iran
| | - Mehri Firozeh
- Department of Nursing, Islamic Azad University, Semnan branch, Semnan, Iran
| |
Collapse
|
18
|
Abstract
Online learning is one of the newest efforts of mainstream healthcare education. It has been cited as providing both an efficient and effective alternative learning medium. This study explored the acceptance of an online orientation program by new healthcare employees and identified several critical factors affecting online learning outcomes. The study applied triangulation methods including surveys, interviews, and test scores. Data were captured from 154 questionnaires (with a response rate of 78.2%) with related test scores and 13 participant interviews. The results showed that new healthcare employees were positive toward the computer-based learning program. "Perceived ease of use" and "perceived usefulness" were the major variables predicting technology acceptance, whereas "learner satisfaction" and "continued intention to use" were the major indices for the learning outcomes. Test scores, however, did not reveal any statistical impact. Additionally, human-computer interaction, instant feedback, and program content were commented on as factors affecting learning outcomes. Therefore, online learning is suitable for new healthcare employees, both in the orientation stage and as a follow-up learning method. The results of this study can help support the development of educational technology online programs.
Collapse
|
19
|
Sockolow PS, Bowles KH, Adelsberger MC, Chittams JL, Liao C. Challenges and facilitators to adoption of a point-of-care electronic health record in home care. Home Health Care Serv Q 2014; 33:14-35. [PMID: 24528226 PMCID: PMC7213645 DOI: 10.1080/01621424.2013.870098] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Electronic health records (EHRs), intended to improve the clinical process, are understudied in home care. The researchers assessed clinician satisfaction, informed by workflow and patient outcomes, to identify EHR adoption challenges. The mixed methods study setting was a Philadelphia agency with 137 clinicians. Adoption challenges included: (a) hardware problems coupled with lack of field support; (b) inadequate training; and (c) mismatch of EHR usability/functionality and workflow resulting in decreased efficiency. Adoption facilitators were support for team communication and improved clinical data timeliness. Opportunities for improved adoption included sharing with front-line clinicians EHR data related to patient care and health outcomes.
Collapse
Affiliation(s)
- Paulina S. Sockolow
- Asst. Prof, Drexel University College of Nursing and Health Professions, Philadelphia, PA, USA
| | - Kathryn H. Bowles
- Prof, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | | | | | - Cindy Liao
- Instructor, Temple University College of Health Professions and Social Work, Philadelphia, PA, USA
| |
Collapse
|
20
|
Hao ATH, Wu LP, Kumar A, Jian WS, Huang LF, Kao CC, Hsu CY. Nursing process decision support system for urology ward. Int J Med Inform 2013; 82:604-12. [PMID: 23523383 DOI: 10.1016/j.ijmedinf.2013.02.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2012] [Revised: 02/14/2013] [Accepted: 02/15/2013] [Indexed: 11/25/2022]
Abstract
PURPOSE We developed a nursing process decision support system (NPDSS) based on three clinical pathways, including benign prostatic hypertrophy, inguinal hernia, and urinary tract stone. NPDSS included six major nursing diagnoses - acute pain, impaired urinary elimination, impaired skin integrity, anxiety, infection risk, and risk of falling. This paper aims to describe the design, development and validation process of the NPDSS. METHODS We deployed the Delphi method to reach consensus for decision support rules of NPDSS. A team of nine-member expert nurses from a medical center in Taiwan was involved in Delphi method. The Cronbach's α method was used for examining the reliability of the questionnaire used in the Delphi method. The Visual Basic 6.0 as front-end and Microsoft Access 2003 as back-end was used to develop the system. A team of six nursing experts was asked to evaluate the usability of the developed systems. A 5-point Likert scale questionnaire was used for the evaluation. The sensitivity and specificity of NPDSS were validated using 150 nursing chart. RESULTS The study showed a consistency between the diagnoses of the developed system (NPDSS) and the nursing charts. The sensitivities of the nursing diagnoses including acute pain, impaired urinary elimination, risk of infection, and risk of falling were 96.9%, 98.1%, 94.9%, and 89.9% respectively; and the specificities were 88%, 49.5%, 62%, and 88% respectively. We did not calculate the sensitivity and specificity of impaired skin integrity and anxiety due to non-availability of enough sample size. CONCLUSIONS NPDSS can help nurses in decision making of nursing diagnoses. Besides, it can help them to generate nursing diagnoses based on patient-specific data, individualized care plans, and implementation within their usual nursing workflow.
Collapse
Affiliation(s)
- Angelica Te-Hui Hao
- Department of Nursing, Chang Gung University of Science and Technology, Taiwan
| | | | | | | | | | | | | |
Collapse
|
21
|
Garcia-Smith D, Effken JA. Development and initial evaluation of the Clinical Information Systems Success Model (CISSM). Int J Med Inform 2013; 82:539-52. [PMID: 23497819 DOI: 10.1016/j.ijmedinf.2013.01.011] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2010] [Revised: 01/03/2013] [Accepted: 01/24/2013] [Indexed: 10/27/2022]
Abstract
PURPOSE Most clinical information systems (CIS) today are technically sound, but the number of successful implementations of these systems is low. The purpose of this study was to develop and test a theoretically based integrated CIS Success Model (CISSM) from the nurse perspective. METHODS Model predictors of CIS success were taken from existing research on information systems acceptance, user satisfaction, use intention, user behavior and perceptions, as well as clinical research. Data collected online from 234 registered nurses in four hospitals were used to test the model. Each nurse had used the Cerner Power Chart Admission Health Profile for at least 3 months. RESULTS Psychometric testing and factor analysis of the 23-item CISSM instrument established its construct validity and reliability. Initial analysis showed nurses' satisfaction with and dependency on CIS use predicted their perceived CIS use Net Benefit. Further analysis identified Social Influence and Facilitating Conditions as other predictors of CIS user Net Benefit. The level of hospital CIS integration may account for the role of CIS Use Dependency in the success of CIS. CONCLUSIONS Based on our experience, CISSM provides a formative as well as summative tool for evaluating CIS success from the nurse's perspective.
Collapse
Affiliation(s)
- Dianna Garcia-Smith
- College of Nursing, The University of Texas at Brownsville, Brownsville, TX, United States.
| | | |
Collapse
|
22
|
Community-based, interdisciplinary geriatric care team satisfaction with an electronic health record: a multimethod study. Comput Inform Nurs 2012; 30:300-11. [PMID: 22411417 DOI: 10.1097/ncn.0b013e31823eb561] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This multimethod study measured the impact of an electronic health record (EHR) on clinician satisfaction with clinical process. Subjects were 39 clinicians at a Program of All-inclusive Care for Elders (PACE) site in Philadelphia utilizing an EHR. Methods included the evidence-based evaluation framework, Health Information Technology Research-Based Evaluation Framework, which guided assessment of clinician satisfaction with surveys, observations, follow-up interviews, and actual EHR use at two points in time. Mixed-methods analysis of findings provided context for interpretation and improved validity. The study found that clinicians were satisfied with the EHR; however, satisfaction declined between time periods. Use of EHR was universal and wide and was differentiated by clinical role. Between time periods, EHR use increased in volume, with increased timeliness and decreased efficiency. As the first EHR evaluation at a PACE site from the perspective of clinicians who use the system, this study provides insights into EHR use in the care of older people in community-based healthcare settings.
Collapse
|
23
|
Abstract
This study proposed an evaluation model, derived from the Technology Acceptance Model and Information System Success Model, to explore factors influencing the acceptance of hospital information systems by nurses. Although many healthcare institutions have applied hospital information systems, relatively few studies have investigated the perceptions of nurses regarding the usefulness, ease of use, or acceptance of these systems. This study recruited the nursing staff of a regional hospital in Taiwan. A total of 297 questionnaires were sent, and 277 were returned, for a response rate of 93.3%. The results indicated that system quality, information quality, and service quality were positively correlated with the perceived ease of use (R=0.69) and perceived usefulness (R=0.72). Information quality has the greatest influence on perceived usefulness (γ3=0.57, P<.001) and ease of use (γ4=0.61, P<.001). Perceived usefulness and ease of use have a significant influence on system acceptance (R=0.75). Perceived usefulness (β1=0.61, P<.001) has a significant influence on system acceptance. These findings indicated that nursing care requires high-quality healthcare information to support the daily activities of nursing professionals. The results of this study also provide a valuable reference for hospital administrators in developing hospital information systems.
Collapse
|
24
|
Nykänen P, Kaipio J, Kuusisto A. Evaluation of the national nursing model and four nursing documentation systems in Finland – Lessons learned and directions for the future. Int J Med Inform 2012; 81:507-20. [DOI: 10.1016/j.ijmedinf.2012.02.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2011] [Revised: 01/30/2012] [Accepted: 02/04/2012] [Indexed: 10/28/2022]
|
25
|
Hung WH, Chang LM, Lee MH. Factors Influencing the Success of National Healthcare Services Information Systems. JOURNAL OF GLOBAL INFORMATION MANAGEMENT 2012. [DOI: 10.4018/jgim.2012070104] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
By extending the updated D&M IS success model, this study examines the multi-dimensional aspects to identify influential factors and construct a suitable model for explaining NHSS success in Taiwan. Through the empirical results from the perspective of 1215 public healthcare workers, this study has arrived at several findings. First, eight salient factors were found which influenced NHSS success from the dimensions of user characteristics, organizational context, and system characteristics. Second, the factors of user experience, user training, information quality, service quality, and user satisfaction have a strong positive effect on system use, whereas user attitude and facilitating conditions have a significant and negative effect. Further, user attitude, user training, top management support, system quality, information quality, and service quality are also significantly correlated to user satisfaction. The results of this study can assist governments in other countries in developing more effective NHSS and better e-Government practices.
Collapse
Affiliation(s)
- Wei-Hsi Hung
- National Chung Cheng University, Advanced Institute of Manufacturing with High-tech Innovations (AIM-HI), Taiwan
| | | | | |
Collapse
|
26
|
Abstract
AIM(S) This literature review examines the current trend in nurses' attitudes toward healthcare information technology (HIT). BACKGROUND HIT implementation and expansion are at the core of global efforts to improve healthcare quality and patient safety. As a large portion of the healthcare workforce, nurses' attitudes towards HIT are likely to have a major impact on the electronic health record (EHR) implementation process. EVALUATION A search of PubMed, CINAHL and Medline databases produced 1930 combined hits. Returned articles were scanned for relevancy and applicability. Thirteen articles met all criteria and were subsequently reviewed in their entirety. KEY ISSUE(S) In accordance with two change theories, if HIT implementation projects are to be successful, nurses must recognize that incorporating EHRs into their daily practice is beneficial to patient outcomes. CONCLUSION(S) Overall, the attitudes of nurses toward HIT are positive. Increased computer experience is the main demographic indicator for positive attitudes. The most common detractors are poor system design, system slowdown and system downtime. Nurses are also fearful that the use of technology will dehumanize patient care. IMPLICATIONS FOR NURSING MANAGEMENT Involving nurses in system design is likely to improve post-implementation satisfaction. Creating a positive, supportive atmosphere appears to be instrumental to sustainability.
Collapse
Affiliation(s)
- Laurie A Huryk
- Clinical Information Systems, Visiting Nurse Association of Central Jersey Community Health Center, Inc., Family Medicine Center of CentraState Medical Center, Toms River, New Jersey 08753, USA.
| |
Collapse
|
27
|
Sockolow P, Weiner J, Bowles K, Abbott P, Lehmann H. Advice for Decision Makers Based on an Electronic Health Record Evaluation at a Program for All-inclusive Care for Elders Site. Appl Clin Inform 2011; 2:18-38. [PMID: 23616858 PMCID: PMC3631909 DOI: 10.4338/aci-2010-09-ra-0055] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2010] [Accepted: 01/01/2011] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Provide evidence-based advise to "Program of All-inclusive Care for the Elderly" (PACE) decision makers considering implementing an electronic health record (EHR) system, drawing on the results of a mixed methods study to examine: (1) the diffusion of an EHR among clinicians documenting direct patient care in a PACE day care site, (2) the impact of the use of the EHR on the satisfaction levels of clinicians, and (3) the impact of the use of the EHR on patient functional outcomes. METHODS Embedded mixed methods design with a post-test design quantitative experiment and concurrent qualitative component. Quantitative methods included: (1) the EHR audit log used to determine the frequency and timing during the week of clinicians' usage of the system; (2) a 22-item clinician satisfaction survey; and (3) a 16-item patient functional outcome questionnaire related to locomotion, mobility, personal hygiene, dressing, feeding as well the use of adaptive devices. Qualitative methods included observations and open-ended, semi-structured follow-up interviews. Qualitative data was merged with the quantitative data by comparing the findings along themes. The setting was a PACE utilizing an EHR in Philadelphia: PACE manages the care of nursing-home eligible members to enable them to avoid nursing home admission and reside in their homes. Participants were 39 clinicians on the multi-disciplinary teams caring for the elders and 338 PACE members. RESULTS Clinicians did not use the system as intended, which may help to explain why the benefits related to clinical processes and patient outcomes as expected for an EHR were not reflected in the results. Clinicians were satisfied with the EHR, although there was a non-significant decline between 11 and 17 months post implementation of the EHR. There was no significant difference in patient functional outcome the two time periods. However, the sample size of 48 was too small to allow any conclusive statements to be made. Interpretation of findings underscores the importance of the interaction of workflow and EHR functionality and usability to impact clinician satisfaction, efficiency, and clinician use of the EHR. CONCLUSION This research provides insights into EHR use in the care of the older people in community-based health care settings. This study assessed the adoption of an EHR outside the acute hospital setting and in the community setting to provide evidence-based recommendations to PACE decision makers considering implementing an EHR.
Collapse
Affiliation(s)
- P.S. Sockolow
- College of Nursing and Health Professions, Drexel University,Philadelphia, PA
| | | | - K.H. Bowles
- University of Pennsylvania School of Nursing,Philadelphia, PA
| | - P. Abbott
- School of Nursing, The Johns Hopkins University,Baltimore, MD
| | | |
Collapse
|
28
|
Confidence in the use of information management and technology (IM&T) in radiography: Is age a barrier? Radiography (Lond) 2010. [DOI: 10.1016/j.radi.2010.01.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
29
|
Abstract
The purpose of this study was to evaluate the impact of a nursing information system on nurses' daily practice. A multimethod evaluation was used that combined both quantitative and qualitative approaches to explore the influence of this technology from different perspectives. The data collection methods included the following: an evaluation scale of the system function, focus group interviews about the users' experiences, and work sampling observation of their work pattern. The data were collected from October to December 2006. The data analysis contained 623 valid questionnaires, 24 nurses' interview content, and 22830 observed nursing activities. Overall, the results indicated that nurses gave a positive evaluation of the technology in their work routine. However, they were concerned about the inadequacy of the hardware devices and response time, training and workflow change, and personal interactions with physicians and patients. Nurses on the night shift spent more time on documentation than on any other nursing activities during the three shifts. The users' technology adoption could be attributed to device sufficiency and function, content design, and workflow efficiency. It is recommended that organizations provide sufficient computer devices, ensure the content design for nursing documentation, and implement expectations for interdisciplinary cooperation.
Collapse
|