The evaluation of the compatibility of electronic patient record (EPR) system with nurses’ management needs in a developing country

Effects of HIS-based intervention on patient education process and patient satisfaction with nurses' education

OBJECTIVE

This quasi-experimental study (before and after intervention) was designed to determine the impact of hospital information system-based intervention on the patient education process and patient satisfaction in cardiac and cardiac intensive care units.

RESULTS

Each nurse was observed at the time of patient education on average on eight shifts (total of 256 shifts), and at last 1350 computerized reports before and after the intervention were analyzed and 150 patient satisfaction with nurses' education questionnaires were completed before and after the intervention. After the intervention, the patient education scores were significantly improved (p < 0.001). In addition, the results of a survey of patients about the level of satisfaction with the quality of patient education showed a significant increase compared to before the intervention (p < 0.001). The ability to easily, completely, and quickly edit and record the provided education, eased the process of patient education and documentation.

A study of the relationship between nurses' experience, structural empowerment, and attitudes toward computer use

Objective

This study examined the relationship between structural empowerment and nurses' experience and attitudes toward computer use.

Methods

This study was conducted using a cross-sectional quantitative design. A total of 184 registered nurses from four hospitals in Jordan participated in the current study. Data were collected using a demographics questionnaire, the Conditions for Work Effectiveness Questionnaire-II (CWEQ-II), and the Pretest for Attitudes toward Computers in Healthcare (PATCH).

Results

The median of experience in years among nurses was 5.0, ranging from one to 26 years. The mean score for the attitudes toward computer use was 61.90 ± 11.38. Almost half of the participants, 45.11%, were in the category of "feel comfortable using user-friendly computers." The participants' mean average of the total structural empowerment was 12.40 ± 2.43, and the values for its four subscales were: opportunity 3.57 ± 0.87, resources 2.83 ± 0.85, information 3.06 ± 0.79, and support 2.95 ± 0.86. The frequencies analysis revealed that most participants had a moderate level of empowerment (n = 127, 69.02%). The bivariate correlation between nurses' experience and attitudes toward computer use was significant (r = -0.17, P < 0.05). The relationship between the total structural empowerment score and attitudes toward computer use was positive but weak (r = 0.20, P < 0.01).

Conclusion

The results indicated that more experienced nurses are more reluctant toward computer use. However, creating an empowering work environment can facilitate nurses' attitudes toward computer use.

The adoption of electronic records management system (ERMS) in the Yemeni oil and gas sector

Purpose

Identification of factors for electronic records management system (ERMS) adoption is important as it allows organizations to focus their efforts on these factors to ensure success. The purpose of this paper is to identify the factors that influence ERMS adoption in the Yemeni oil and gas (O&G) sector.

Design/methodology/approach

This paper conducts a systematic literature review (SLR) to extract the most common factors that could facilitate successful ERMS adoption. Information technology (IT) experts were asked to rank the extracted factors via an e-mail questionnaire and to recommend specific critical success factors that must be given extra attention to increasing the success of ERMS adoption. Essentially, the proposed methodology is technology-organization-environment (TOE) modeling to examine the important factors influencing decision-makers in the Yemeni O&G sector regarding ERMS adoption.

Findings

This paper identifies factors influencing ERMS adoption based on SLR and an expert-ranking survey. The data that were collected from IT experts were analyzed using the statistical package for the social sciences. The results showed that only 12 out of 20 factors were significant. The experts then added three new factors, resulting in 15 significant factors classified into the three dimensions as follows: technology, organization and environment.

Originality/value

Limited studies have been carried out in the context of the O&G sector, even among developed countries such as Canada, the UK and Australia. These studies have focused on a limited number of factors for ERMS adoption targeting better utilization of human resources, faster and more user-friendly system responses and suitability for organizational ease. This paper explores the factors that may prove useful in adopting of ERMS in the O&G sector of developing countries, similar to Yemen.

Information Technology-Assisted Treatment Planning and Performance Assessment for Severe Thalassemia Care in Low- and Middle-Income Countries: Observational Study

Background

Successful models of information and communication technology (ICT) applied to cost-effective delivery of quality care in low- and middle-income countries (LMIC) are an increasing necessity. Severe thalassemia is one of the most common life-threatening noncommunicable diseases of children globally.

Objective

The aim was to study the impact of ICT on quality of care for severe thalassemia patients in LMIC.

Methods

A total of 1110 patients with severe thalassemia from five centers in India were followed over a 1-year period. The impact of consistent use of a Web-based platform designed to assist comprehensive management of severe thalassemia (ThalCare) on key indicators of quality of care such as minimum (pretransfusion) hemoglobin, serum ferritin, liver size, and spleen size were assessed.

Results

Overall improvements in initial hemoglobin, ferritin, and liver and spleen size were significant (P<.001 for each). For four centers, the improvement in mean pretransfusion hemoglobin level was statistically significant (P<.001). Four of five centers achieved reduction in mean ferritin levels, with two displaying a significant drop in ferritin (P=.004 and P<.001). One of the five centers did not record liver and spleen size on palpation, but of the remaining four centers, two witnessed a large drop in liver and spleen size (P<.01), one witnessed moderate drop (P=.05 for liver; P=.03 for spleen size), while the fourth witnessed a moderate increase in liver size (P=.08) and insignificant change in spleen size (P=.12).

Conclusions

Implementation of computer-assisted treatment planning and performance assessment consistently and positively impacted indexes reflecting effective delivery of care to patients suffering from severe thalassemia in LMIC.

The role of digital health in making progress toward Sustainable Development Goal (SDG) 3 in conflict-affected populations

PURPOSE

The progress of the Millennium Development Goals (MDGs) shows that sustained global action can achieve success. Despite the unprecedented achievements in health and education, more than one billion people, many of them in conflict-affected areas, were unable to reap the benefits of the MDG gains. The recently developed Sustainable Development Goals (SDGs) are even more ambitious then their predecessor. SDG 3 prioritizes health and well-being for all ages in specific areas such as maternal mortality, communicable diseases, mental health, and healthcare workforce. However, without a shift in the approach used for conflict-affected areas, the world's most vulnerable people risk being left behind in global development yet again. We must engage in meaningful discussions about employing innovative strategies to address health challenges fragile, low-resource, and often remote settings. In this paper, we will argue that to meet the ambitious health goals of SDG 3, digital health can help to bridge healthcare gaps in conflict-affected areas.

METHODS

First, we describe the health needs of populations in conflict-affected environments, and how they overlap with the SDG 3 targets. Secondly, we discuss how digital health can address the unique needs of conflict-affected areas. Finally, we evaluate the various challenges in deploying digital technologies in fragile environments, and discuss potential policy solutions.

DISCUSSION

Persons in conflict-affected areas may benefit from the diffusive nature of digital health tools. Innovations using cellular technology or cloud-based solutions overcome physical barriers. Additionally, many of the targets of SDG 3 could see significant progress if efficacious education and outreach efforts were supported, and digital health in the form of mHealth and telehealth offers a relatively low-resource platform for these initiatives. Lastly, lack of data collection, especially in conflict-affected or otherwise fragile states, was one of the primary limitations of the MDGs. Greater investment in data collection efforts, supported by digital health technologies, is necessary if SDG 3 targets are to be measured and progress assessed. Standardized EMR systems as well as context-specific data warehousing efforts will assist in collecting and managing accurate data. Stakeholders such as patients, providers, and NGOs, must be proactive and collaborative in their efforts for continuous progress toward SDG 3. Digital health can assist in these inter-organizational communication efforts.

CONCLUSION

The SDGS are complex, ambitious, and comprehensive; even in the most stable environments, achieving full completion towards every goal will be difficult, and in conflict-affected environments, this challenge is much greater. By engaging in a collaborative framework and using the appropriate digital health tools, we can support humanitarian efforts to realize sustained progress in SDG 3 outcomes.

Success or failure of hospital information systems of public hospitals affiliated with Zahedan University of Medical Sciences: A cross sectional study in the Southeast of Iran

INTRODUCTION

After implementation, evaluation of hospital information systems (HISs) is critical to ensure the fulfillment of the system goals. This study aimed to assess the success or failure of HISs in public hospitals affiliated with Zahedan University of Medical Sciences.

MATERIALS AND METHODS

A cross-sectional descriptive and analytic study was performed in 2016. The study population comprised IT and HIS authorities and hospital information system users. The sample consisted of 468 participants. The data were collected using two questionnaires and analyzed with the SPSS software using descriptive and analytical statistics.

RESULTS

The mean score of functional, behavioral, ethical, organizational, cultural and educational factors from the users' perspective was 3.14±0.66, 2.97± 0.60, 3.39±0.70, 2.96±0.642, 3.09±0.63, and 2.95±0.74, respectively. The mean score of organizational, behavioral, cultural, technological, educational and legal factors from IT and HIS authorities' perspective was 3.51±0.54, 3.35±0.45, 2.75±0.61, 3.58±0.32, and 3.96±0.59, respectively.

CONCLUSIONS

The evaluated hospital information systems were considered relatively successful in terms of functional, ethical, and cultural factors but were considered as a relative failure in terms of behavioral, organizational, and educational factors form the users' perspective. Only the legal factor showed success, while organizational, behavioral, technical and educational factors showed relative success and the cultural factor showed relative failure from HIS and IT authorities' perspective. Therefore, assessing the users' needs before implementing the system, involving them in various stages of implementation, training them, and improving their computer skills seem to be necessary to achieve a better level of system success.

Evaluation of Nursing Information Systems: Application of Usability Aspects in the Development of Systems

Objectives

As the largest group providing healthcare services, nurses require well-designed information systems in their practice. This study aims to evaluate the usability of nursing information systems (NIS).

Methods

This cross-sectional survey was conducted in 2015. The settings of the study consisted of four hospitals affiliated with three medical universities in Tehran (Iran). The subjects of the study included nurses who had access to and used a NIS developed by four major software companies. The data were collected using a modified version of a usability questionnaire known as IsoMetrics, based on the International Standard ISO 9241, Part 11. The questionnaire is composed of 35 questions divided into seven general criteria. The validity of the questionnaire was determined by experts in the field, and the reliability was checked using Cronbach's alpha (α = 0.91). The questionnaire was then distributed to 184 nurses.

Results

The response rate was 64.6%. Among the seven ISO usability criteria, suitability for the task (3.10 ± 1.24) and suitability for learning (3.10 ± 1.27) had the highest mean value. The lowest mean value (2.37 ± 1.29) was related to the suitability for individualization.

Conclusions

Addressing issues related to individualization and self-descriptiveness could improve the usability of nursing systems. Considering usability requirements in the design of a NIS will lead to the efficient and effective use of these systems.

Confirmation of Expectations and Satisfaction with Hospital Information Systems: A Nursing Perspective

OBJECTIVES

This study aimed to compare nurses' satisfaction with, and expectations of, hospital information systems in two teaching hospitals.

METHODS

This was a survey study, which was completed in 2014. The potential participants were 267 nurses who worked in two teaching hospitals and used the same hospital information system. Data were collected using two questionnaires. Both questionnaires were examined in terms of content validity and reliability.

RESULTS

The results showed that, for a majority of nurses, their expectations of the system were not met in either hospital. Moreover, there was a significant association between the nurses' expectations and the perceived usefulness of the systems (p < 0.001), between the nurses' expectations and their satisfaction with the systems (p < 0.001), and between the perceived usefulness and nurses' satisfaction with the systems (p < 0.001).

CONCLUSIONS

The results suggested that, apart from the technical issues of implementing clinical information systems, non-technical factors should be taken into account. Among them, the nature of clinical tasks and the organizational culture require more attention to allow a successful system to be designed and implemented.

Concerns and hopes about outsourcing decisions regarding health information management services at two teaching hospitals in Semnan, Iran

BACKGROUND

Changes in health programs in Iran have led to an increase in administrative costs. One cost-saving option available to hospital administrators is to outsource administrative services.

OBJECTIVE

This study aimed to explore the attitudes of hospital staff towards outsourcing health information management services in advance of a decision being taken, to assist healthcare organisations to assess the potential benefits and challenges of outsourcing such services.

METHOD

Six hundred and four clinical and allied health employees in two hospitals in Iran, who had had prior experience with outsourcing hospital services, responded to a survey designed to measure staff attitudes towards outsourcing health information management services, based on their perceptions of potential costs and benefits for the organisation and their own employment prospects. A 16-item attitude scale, developed by the researchers, was used in the study and demographic data were also collected.

RESULTS

Summary statistics showed that approximately one third of the sample (34.53%) had a negative view of outsourcing, one third (35.16%) had a positive view, and 30.31% were neutral. An exploratory factor analysis of items on the attitude scale identified three underlying constructs, labelled: data security and management; workplace environment; and staff and customer satisfaction. One item (concern about the impact of outsourcing on staffing levels) did not load on any of the factors. A separate analysis of this single item showed a significant relationship between the sex of participants and their views on the impact of outsourcing on the number of hospital staff employed (p<0.05).

CONCLUSION

While results of this study indicated that staff in hospitals surveyed held both positive and negative views of outsourcing, a large number of staff in these hospitals (a third of the total sample) had reservations about the skills of outside providers to securely manage hospital data, and did not consider that outsourcing health information management services would be positive for the organisation, their working environment or for staff and patient satisfaction. These findings have important implications for healthcare organisations planning to outsource health information services. Further research that focuses on communication skills of senior managers and their ability to provide team leadership is needed, as is research into the impact of geographical location and current market forces that impact on outsourcing tasks.

The moderating effects of demographic and individual characteristics on nurses' acceptance of information systems: A canadian study

OBJECTIVES

The purpose of this study was to educate on the moderating effects of demographic (i.e., educational level and age) and individual characteristics (i.e., years of nursing experience and computer knowledge) on nurses' acceptance of information systems (IS). The technology acceptance model (TAM) with its constituent variables such as perceived usefulness (PUSS) and perceived ease of use (PEOU) was the theoretical framework used for this study.

METHODS

A cross-sectional study was conducted in Nova Scotia, Canada. Usable data was collected from 197 registered nurses (RNs). Relevant hypotheses were formulated and the partial least squares (PLS) technique was used for data analysis.

RESULTS

The results of the hypothesized relationships showed that education and computer knowledge have positive moderating effects on the influences of PEOU and PUSS on nurses' attitudes toward IS (ATTI). The factors of nurses' years of nursing experience and age did not yield meaningful results. ATTI impacted behavioral intentions to use IS, which positively impacted nurses' use of IS. The nurses sampled in the study have positive IS use behaviors.

CONCLUSIONS

This study demonstrates that relevant demographic factors and individual characteristics, if incorporated into frameworks used for investigating nurses' acceptance of IS, could permit the emergence of useful insights for practitioners and researchers. Specifically, this study showed that nurses with higher educational attainments and more basic computer knowledge readily accept implemented IS at work. Hospital administrators benefit from insights such as the one presented in this study.

THE DETERMINANTS OF NURSING, ALLIED HEALTH AND NON MEDICAL STAFFS' HEALTH LITERACY IN HOSPITALS OF A DEVELOPING COUNTRY

INTRODUCTION

Given the role of personnel working in hospitals in promoting health, there is a clear need for a study to clarify the level of health literacy and affecting factors on it among the non medical and medical staffs working in hospitals.

METHODS

A cross-sectional survey was performed on 389 employees who were working in hospitals affiliated to Semnan University of Medical Sciences of Iran in 2013.

RESULTS

There were significant relationships among the use of TV (P=0.044, CI=95%, Odd's Ratio= 1.825), the use of books and journals (P<0.0001, CI=95%, Odd's Ratio= 5.551), the use of internet (P<0.039, CI=95%, Odd's Ratio= 0.641), the use of physicians (P<0.0001, CI=95%, Odd's Ratio=0.070) and the nonmedical and medical staffs' health literacy level.

CONCLUSIONS

The findings indicate media and print information resources more than physicians and electronic information sources affect on the increase of nonmedical and medical staffs' health literacy of hospitals of Iran. It also is better to train Iranian physicians more about the skills required for transferring health concepts. Given the important role of medical staffs in the increase of health literacy level in other members of the community, it is better to use other suitable information sources to transfer health information to all individuals in the community.