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Özduyan Kılıç M, Korkmaz F. Adaptation of the Workflow Integration Survey to Turkey: A Validity and Reliability Study. J Nurs Meas 2024; 32:174-182. [PMID: 37348887 DOI: 10.1891/jnm-2022-0025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
Background and Purpose: Electronic health record systems (EHRSs) are widely used to record patients' data and should be compatible with nurses' workflow. The purpose of this study was to adapt the Workflow Integration Survey (WIS) to the Turkish language and examine the reliability and validity measures of the Turkish version of the scale. Methods: In this methodological study, data were collected between December 2019 and February 2020 from 120 nurses. This study included the following phases: translation and evaluation of the content validity; explanatory factor analysis and confirmatory factor analysis (CFA) and reliability analysis. The intraclass correlation coefficient (ICC) was used for the test-retest reliability with 30 nurses. Results: The results of CFA revealed a two factors' structure, and these two factors explained 50.57% of the total variance. This was confirmed (χ2/df = 1.673, goodness-of-fit index = 0.948, incremental fit index = 0.923, comparative fit index = 0.918, root mean square error of approximation = 0.075, and standardized root mean square residual = 0.0604) using structural equation modeling. The total Cronbach's alpha value was found to be .702, .636, and .649 for the subscales. The ICC was calculated for test-retest reliability and was found to be 0.871. Conclusions: The validity and reliability of the WIS have been found to be sufficient. It is recommended that the validity and reliability studies on the WIS be conducted in different hospitals with a larger number of participants. Furthermore, the use of the scale in cross-cultural studies to evaluate the compatibility of EHRSs with nurses' workflow in different cultures is also suggested.
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Affiliation(s)
| | - Fatoş Korkmaz
- Faculty of Nursing, Hacettepe University, Ankara, Turkey
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Canfell OJ, Woods L, Meshkat Y, Krivit J, Gunashanhar B, Slade C, Burton-Jones A, Sullivan C. The Impact of Digital Hospitals on Patient and Clinician Experience: Systematic Review and Qualitative Evidence Synthesis. J Med Internet Res 2024; 26:e47715. [PMID: 38466978 PMCID: PMC10964148 DOI: 10.2196/47715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 11/08/2023] [Accepted: 01/31/2024] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND The digital transformation of health care is advancing rapidly. A well-accepted framework for health care improvement is the Quadruple Aim: improved clinician experience, improved patient experience, improved population health, and reduced health care costs. Hospitals are attempting to improve care by using digital technologies, but the effectiveness of these technologies is often only measured against cost and quality indicators, and less is known about the clinician and patient experience. OBJECTIVE This study aims to conduct a systematic review and qualitative evidence synthesis to assess the clinician and patient experience of digital hospitals. METHODS The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and ENTREQ (Enhancing the Transparency in Reporting the Synthesis of Qualitative Research) guidelines were followed. The PubMed, Embase, Scopus, CINAHL, and PsycINFO databases were searched from January 2010 to June 2022. Studies that explored multidisciplinary clinician or adult inpatient experiences of digital hospitals (with a full electronic medical record) were included. Study quality was assessed using the Mixed Methods Appraisal Tool. Data synthesis was performed narratively for quantitative studies. Qualitative evidence synthesis was performed via (1) automated machine learning text analytics using Leximancer (Leximancer Pty Ltd) and (2) researcher-led inductive synthesis to generate themes. RESULTS A total of 61 studies (n=39, 64% quantitative; n=15, 25% qualitative; and n=7, 11% mixed methods) were included. Most studies (55/61, 90%) investigated clinician experiences, whereas few (10/61, 16%) investigated patient experiences. The study populations ranged from 8 to 3610 clinicians, 11 to 34,425 patients, and 5 to 2836 hospitals. Quantitative outcomes indicated that clinicians had a positive overall satisfaction (17/24, 71% of the studies) with digital hospitals, and most studies (11/19, 58%) reported a positive sentiment toward usability. Data accessibility was reported positively, whereas adaptation, clinician-patient interaction, and workload burnout were reported negatively. The effects of digital hospitals on patient safety and clinicians' ability to deliver patient care were mixed. The qualitative evidence synthesis of clinician experience studies (18/61, 30%) generated 7 themes: inefficient digital documentation, inconsistent data quality, disruptions to conventional health care relationships, acceptance, safety versus risk, reliance on hybrid (digital and paper) workflows, and patient data privacy. There was weak evidence of a positive association between digital hospitals and patient satisfaction scores. CONCLUSIONS Clinicians' experience of digital hospitals appears positive according to high-level indicators (eg, overall satisfaction and data accessibility), but the qualitative evidence synthesis revealed substantive tensions. There is insufficient evidence to draw a definitive conclusion on the patient experience within digital hospitals, but indications appear positive or agnostic. Future research must prioritize equitable investigation and definition of the digital clinician and patient experience to achieve the Quadruple Aim of health care.
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Affiliation(s)
- Oliver J Canfell
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia
- Queensland Digital Health Centre, Faculty of Medicine, The University of Queensland, Brisbane, Australia
- Digital Health Cooperative Research Centre, Australian Government, Sydney, Australia
- UQ Business School, Faculty of Business, Economics and Law, The University of Queensland, Brisbane, Australia
| | - Leanna Woods
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia
- Queensland Digital Health Centre, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Yasaman Meshkat
- School of Clinical Medicine, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Jenna Krivit
- School of Clinical Medicine, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Brinda Gunashanhar
- School of Clinical Medicine, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Christine Slade
- Institute for Teaching and Learning Innovation, The University of Queensland, Brisbane, Australia
| | - Andrew Burton-Jones
- UQ Business School, Faculty of Business, Economics and Law, The University of Queensland, Brisbane, Australia
| | - Clair Sullivan
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Australia
- Queensland Digital Health Centre, Faculty of Medicine, The University of Queensland, Brisbane, Australia
- Metro North Hospital and Health Service, Department of Health, Queensland Government, Brisbane, Australia
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Ayamolowo LB, Irinoye OO, Olaniyan AS. Utilization of electronic health records and associated factors among nurses in a faith-based teaching hospital, Ilishan, Nigeria. JAMIA Open 2023; 6:ooad059. [PMID: 37545983 PMCID: PMC10403426 DOI: 10.1093/jamiaopen/ooad059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 03/18/2023] [Accepted: 07/28/2023] [Indexed: 08/08/2023] Open
Abstract
Introduction It has been documented that nurses' use of electronic health records (EHRs) impacts clients' health outcomes positively. Some health facilities, primarily privately owned institutions, introduced EHRs for optimal healthcare. Evidence of such and associated factors among nurses must be documented to improve utilization and quality. Objective The study assessed the utilization of EHRs and associated factors among nurses in a faith-based teaching hospital. Materials and Methods This sequential explanatory mixed-methods study involved a sample of all 240 nurses from a teaching hospital where EHRs have been introduced. Quantitative data through semistructured questionnaires were collected and analyzed using Chi-square and logistic regression. Qualitative data were collected from 10 purposively selected nurses using an in-depth interview guide and analyzed through content analysis. Results The majority of participants reported availability of EHR computer software (62.8%), internet facility (84.2%), and desktops (76.3%), but EHR was poorly utilized (27.3%). Factors significantly associated were nurses who were females [OR (odds ratio) = 1.5, 95% CI (confidence interval), 0.21-11.24], BNSc degrees holders [OR = 4.3; 95% CI, 1.06-17.43]; had computer EHR software [OR = 7.4, 95% CI, 0.83-3.81], and sponsored EHR training [OR = 2.10; 95% CI, 0.24-18.6]. Noncapturing of nursing tasks and nursing standardized language by EHR software, lack of institutional enforcement on EHR use, and absence of clear EHR policies were the main identified themes for the key barriers to using EHRs. Conclusion EHR was poorly utilized among nurses. Gender, educational qualification, EHR resources, and sponsored training were factors significantly associated with the use. There is an urgent need for comprehensive EHR packages, sustained sponsored training, and formulation of EHR policy for effective EHR implementation.
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Affiliation(s)
- Love B Ayamolowo
- Corresponding Author: Love B. Ayamolowo, Department of Nursing Science, Obafemi Awolowo University, Ile-Ife, Osun State 220005, Nigeria;
| | - Omolola O Irinoye
- Department of Nursing Science, Obafemi Awolowo University, Osun State, Nigeria
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Kaihlanen AM, Elovainio M, Virtanen L, Kinnunen UM, Vehko T, Saranto K, Heponiemi T. Nursing informatics competence profiles and perceptions of health information system usefulness among registered nurses: A latent profile analysis. J Adv Nurs 2023; 79:4022-4033. [PMID: 37243421 DOI: 10.1111/jan.15718] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 02/27/2023] [Accepted: 05/05/2023] [Indexed: 05/28/2023]
Abstract
AIMS To identify different nursing informatics competence (NIC) profiles in nurses, examine the factors associated with profile memberships and examine the associations of the derived profiles with the nurses' perception of the usefulness of a health information system (HIS). DESIGN A cross-sectional study. METHODS A sample of 3610 registered nurses responded to a nationwide survey in March 2020. A latent profile analysis was performed to identify NIC profiles based on three competence areas: nursing documentation, working in digital environment, and ethics and data protection. A multinomial logistic regression was carried out to examine the associations of demographic and background variables with the profile membership. Linear regression analyses were carried out to examine the association between the profile membership and perceived HIS usefulness. RESULTS Three NIC profiles were identified and labelled as low, moderate and high competence groups. A younger age, recent graduation year, sufficient orientation and high-rated proficiency as an HIS user were associated with nurses belonging to a high or moderate competence group relative to a low competence group. Competence group membership was associated with perceived HIS usefulness. The high competence group consistently expressed the highest usefulness of the HIS and the low competence group the lowest. CONCLUSION Tailored training and support should be provided for nurses with different levels of informatics competence, thereby facilitating their ability to respond to increasingly digitalized work. This could contribute to higher usefulness of the HIS in terms of supporting the nurses' work tasks and promoting the quality of care. IMPACT This was the first study exploring latent profiles of informatics competence in nurses. Insights from this study are useful for nursing management to identify different competence profiles of their employees, provide support and training to meet their needs, and promote the successful use of an HIS.
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Affiliation(s)
| | - Marko Elovainio
- Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Lotta Virtanen
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Ulla-Mari Kinnunen
- Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland
| | - Tuulikki Vehko
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Kaija Saranto
- Department of Health and Social Management, University of Eastern Finland, Kuopio, Finland
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Alrasheeday AM, Alshammari B, Alkubati SA, Pasay-an E, Albloushi M, Alshammari AM. Nurses' Attitudes and Factors Affecting Use of Electronic Health Record in Saudi Arabia. Healthcare (Basel) 2023; 11:2393. [PMID: 37685427 PMCID: PMC10486676 DOI: 10.3390/healthcare11172393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/13/2023] [Accepted: 08/23/2023] [Indexed: 09/10/2023] Open
Abstract
(1) Background: Nurses' attitudes toward electronic health records (EHRs) is a very valuable issue that needs to be evaluated, understood, and considered one of the main factors that can lead to its improvement or handicap its implementation. This study aimed to assess nurses' attitudes toward EHRs and associated factors that affect the implementation of EHRs in different hospitals in Saudi Arabia. (2) Methods: A cross-sectional study was utilized to collect data from 297 nurses working in public hospitals and primary healthcare centers in Ha'il Province from January to May 2023. Data were collected using the Nurses' Attitudes Towards Computerization questionnaire and a sociodemographic and work-related characteristics sheet. (3) Results: Most of the participants' attitude scores (81.1%, n = 241) were more than or equal to 60, representing positive attitudes, whereas 18.9% (n = 56) of the nurses' scores were less than 60, which is interpreted as negative attitudes. There was a significant relationship between nurses' attitudes toward EHRs and a participants' sex, where males had a more positive attitude than females (p < 0.001). Particularly, young nurses and those who had previous computer experience had a more positive attitude than older nurses and those who had no computer experience (p = 0.044 and < 0.001, respectively). Saudi nurses holding a master's degree had significantly more positive attitudes toward EHRs than non-Saudi nurses holding a bachelor's or diploma degree (p = 0.007 and 0.048, respectively). Nurses with less experience (less than five years) in the nursing field had a significantly positive attitude. Multiple linear regression showed that sex (p = 0.038), level of education (p = 0.001), and previous computer experience (p < 0.001) were independent factors of nurses' knowledge of EHRs. (4) Conclusion: The majority of nurses had positive overall attitudes toward using EHRs. Nurses who are Saudi nationals, male, younger, have previous computer experience, and have less than five years of experience had a more positive attitude toward EHRs than nurses who are non-Saudi, female, older, have no computer experience, have bachelor's or diploma degree, and have less than five years of experience, respectively. Sex, education level, and previous computer experience were independent factors of nurses' knowledge of EHRs.
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Affiliation(s)
- Awatif M. Alrasheeday
- Nursing Administration Department, College of Nursing, University of Hail, Hail 2440, Saudi Arabia;
| | - Bushra Alshammari
- Medical Surgical Nursing Department, College of Nursing, University of Hail, Hail 2440, Saudi Arabia;
| | - Sameer A. Alkubati
- Medical Surgical Nursing Department, College of Nursing, University of Hail, Hail 2440, Saudi Arabia;
- Department of Nursing, Faculty of Medicine and Health Sciences, Hodeida University, Hodeida P.O. Box 3114, Yemen
| | - Eddieson Pasay-an
- Maternal and Child Nursing Department, College of Nursing, University of Hail, Hail 2440, Saudi Arabia;
| | - Monirah Albloushi
- Medical Surgical Department, College of Nursing, King Saud University, Riyadh 11451, Saudi Arabia;
| | - Awayed M. Alshammari
- Nursing Administration, King Khalid General Hospital, Ministry of Health, Hafar Al Batin 39921, Saudi Arabia;
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Kasaye MD, Mengestie ND, Beyene S, Kebede N, Ngusie HS, Kalayou MH. Acceptance of electronic medical records and associated factor among physicians working in University of Gondar comprehensive specialized hospital: A cross-sectional study. Digit Health 2023; 9:20552076231213445. [PMID: 38025113 PMCID: PMC10652805 DOI: 10.1177/20552076231213445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 10/25/2023] [Indexed: 12/01/2023] Open
Abstract
Objective Electronic Medical Records (EMRs) are digitalized medical record systems that collect, store, and display patient data. It is individual patient clinical information electronically gathered and made instantly available to all physicians in the healthcare chain, assisting in the delivery of coherent and consistent care. However, the acceptance of the electronic medical record status of physicians in Ethiopia is limitedly known due to knowledge, attitude, and computer skill gaps. This study aims to assess the acceptance of electronic medical records and associated factors among physicians working in Ethiopia. Methods A cross-sectional study was conducted among physicians working in Gondar Comprehensive Specialized Hospital. A total of 205 physicians were included. Data were collected through a self-administered structured questionnaire. Descriptive and Logistic regression were conducted. Result A one hundred ninety-eight participants returned the questionnaire from the total yielding a response rate of 96.6%. The proportion of those who have good acceptance for EMR was 72.2% and about 48.5%, 78.3%, and 59.6%, were sufficient computer skills, Good knowledge, and a favorable attitude toward EMR respectively. Age ≤ 30 years (AOR = 0.13 (0.02, 0.57), working experience AOR = 0.15 (0.04, 0.54), working department AOR = 0.09 (0.01, 0.90), good computer skills AOR = 8.42 (6.45, 16.02), Good knowledge AOR = 5.21 (1.22, 12.28), and favorable attitude AOR = 15.24 (12.06, 25.94) were significantly associated towards EMR acceptance. Conclusion Generally, in this study, physicians' acceptance of electronic medical records was good. Age, year of experience, working department, good computer skills, good knowledge, and favorable attitude were significantly associated with physicians' acceptance of the electronic medical record. Improving computer skills, enhancing positive attitudes, and increasing the knowledge of the health care professionals are vital interventions to enhance and improve the acceptance of EMR system in the study area.
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Affiliation(s)
- Mulugeta Desalegn Kasaye
- Department of Health Informatics, School of Public Health College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Nebyu Demeke Mengestie
- Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Sara Beyene
- Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Natnael Kebede
- Department of Health Informatics, School of Public Health College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Habtamu Setegn Ngusie
- Department of Health Informatics, School of Public Health, College of Medicine and Health Sciences, Woldia University, Woldia, Ethiopia
| | - Mulugeta Hayelom Kalayou
- Department of Health Informatics, School of Public Health College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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Dubale AT, Mengestie ND, Tilahun B, Walle AD. User Satisfaction of Using Electronic Medical Record System and Its Associated Factors among Healthcare Professionals in Ethiopia: A Cross-Sectional Study. BIOMED RESEARCH INTERNATIONAL 2023; 2023:4148211. [PMID: 37101688 PMCID: PMC10125755 DOI: 10.1155/2023/4148211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 03/29/2023] [Accepted: 04/07/2023] [Indexed: 04/28/2023]
Abstract
Background Electronic medical record (EMR) systems have become essential for the proper management of patients' information. Electronic medical record systems are on the rise in developing countries due to the need to ensure improved quality of healthcare. However, EMR systems can be ignored, if users are not satisfied with the implemented system. User dissatisfaction has been associated with the failure of EMR systems as a primary factor. There is also limited research done in the Ethiopian context on EMR user satisfaction at private hospitals. This study is aimed at assessing user satisfaction with electronic medical records and associated factors among health professionals working at private hospitals in Addis Ababa. Methods Institution-based cross-sectional quantitative study was conducted among health professionals working at private hospitals in Addis Ababa, from March to April 2021. A self-administered questionnaire was used to collect the data. EpiData version 4.6 and Stata version 25 were used for data entry and analysis, respectively. Descriptive analyses were computed for the study variables. Bivariable and multivariable logistic regression analyses were carried out to assess the significance of independent variables on dependent variables. Results A total of 403 (95.33% response rate) participants completed all the questionnaires. More than half of 214 (53.10%) of the participants were satisfied with the EMR system. Factors associated with user satisfaction with electronic medical records were good computer literacy (AOR = 2.92, 95% CI: [1.16-7.37]), perceived information quality (AOR = 3.54, 95% CI: [1.55-8.11]), perceived service quality (AOR = 3.15, 95% CI: [1.58-6.28]), perceived system quality (AOR = 3.05, 95% CI: [1.32-7.05]), EMR training (AOR = 4.00, 95% CI: [1.76-9.03]), computer access (AOR = 3.17, 95% CI: [1.19-8.46]), and HMIS training (AOR = 2.05, 95% CI: [1.22-6.71]). Conclusions In this study, health professionals' EMR satisfaction was moderate. The result showed that EMR training, computer literacy, computer access, perceived system quality, information quality, service quality, and HMIS training were associated with user satisfaction. Improving computer-related training, system quality, information quality, and service quality is an important intervention to improve the healthcare professional's satisfaction towards using electronic health record systems in Ethiopia.
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Affiliation(s)
- Abiy Tasew Dubale
- Department of Health Informatics, College of Health Science, Mattu University, Metu, Ethiopia
| | - Nebyu Demeke Mengestie
- Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Binyam Tilahun
- Department of Health Informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Agmasie Damtew Walle
- Department of Health Informatics, College of Health Science, Mattu University, Metu, Ethiopia
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Alfuqaha O, Rabay'ah M, Al. khashashneh O, Alsalaht M. Technology acceptance model among nurses and other healthcare providers during the 2019 Coronavirus pandemic: a comparative cross-sectional study. CENTRAL EUROPEAN JOURNAL OF NURSING AND MIDWIFERY 2022. [DOI: 10.15452/cejnm.2022.13.0023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
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Chang HY, Lai PF, Jiang JL. Nurses' Acceptance of and Satisfaction With the Advanced Cardiac Life Support Electronic Information System in Emergency Departments and Critical Care Units. Comput Inform Nurs 2022; 41:00024665-900000000-99186. [PMID: 35234707 DOI: 10.1097/cin.0000000000000888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Emergency and critical care nurses perform an important role in documenting the resuscitation process. However, paper-based recording is labor intensive and complex and may result in incorrect recording of important parameters, which suggests the need for an appropriate electronic information system for emergency care. This cross-sectional descriptive study explores emergency and critical care nurses' acceptance of, and satisfaction with, the newly developed advanced cardiac life support electronic information system and examines whether paper-based recording and electronic recording approaches differ in the completeness of resuscitation records. Data were collected through a self-designed structured questionnaire and a retrospective review of medical records. Data were analyzed by descriptive statistics, independent sample t test, and one-way analysis of variance. The results indicated that novice nurses were more satisfied with the electronic information system than others. Emergency care nurses were significantly more satisfied than medical and surgical ICU nurses. The electronic information system improved the completeness of resuscitation recording by 23.5%, compared with the paper-based recording approach. Emergency and critical care nurses have a moderate to high degree of acceptance of, and satisfaction with, electronic information systems.
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Affiliation(s)
- Hui-Ying Chang
- Author Affiliations: Department of Emergency, Buddhist Tzu Chi General Hospital (Chang and Dr Lai); and School of Medicine (Dr Lai) and Department of Nursing (Dr Jiang), Tzu Chi University, Hualien, Taiwan
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Al-Otaibi J, Tolma E, Alali W, Alhuwail D, Aljunid SM. Factors contributing to physicians’ current use and satisfaction of electronic health records (EHRs) in Kuwait’s public health care: Cross-Sectional Questionnaire Study (Preprint). JMIR Med Inform 2022; 10:e36313. [PMID: 36206039 PMCID: PMC9587489 DOI: 10.2196/36313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 08/02/2022] [Accepted: 09/07/2022] [Indexed: 12/04/2022] Open
Abstract
Background Electronic health record (EHR) has emerged as a backbone health care organization that aims to integrate health care records and automate clinical workflow. With the adoption of the eHealth care system, health information communication technologies and EHRs are offering significant health care advantages in the form of error reduction, improved communication, and patient satisfaction. Objective This study aimed to (1) investigate factors associated with physicians’ EHR adoption status and prevalence of EHRs in Kuwait and (2) identify factors predicting physician satisfaction with EHRs in public hospitals in Kuwait. Methods This study was conducted at Kuwait’s public Al-Jahra hospital from May to September 2019, using quantitative research methods. Primary data were gathered via questionnaires distributed among 295 physicians recruited using convenience sampling. Data were analyzed in SPSS using descriptive, bivariate, and multivariate linear regression, adjusted for demographics. Results Results of the study revealed that the controlled variable of gender (β=–.197; P=.02) along with explanatory variables, such as training quality (β=.068; P=.005), perception of barriers (β=–.107; P=.04), and effect on physician (β=.521; P<.001) have a significant statistical relationship with physicians’ EHR adoption status. Furthermore, findings also suggested that controlled variables of gender (β=–.193; P=.02), education (β=–.164; P=.03), effect on physician (β=.417; P<.001), and level of ease of use (β=.254; P<.001) are significant predictors of the degree of physician satisfaction with the EHR system. Conclusions The findings of this study had significant managerial and practical implications for creating an inductive environment for the acceptance of EHR systems across a broad spectrum of health care system in Kuwait.
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Affiliation(s)
- Jawaher Al-Otaibi
- Department of Health Policy and Management, College of Public Health, Kuwait University, Kuwait City, Kuwait
| | - Eleni Tolma
- Social Behavioral Sciences, College of Public Health, Kuwait Unviersity, Kuwait City, Kuwait
- Department of Education, European University Cyprus, Nicosia city, Cyprus
| | - Walid Alali
- Department of Health Policy and Management, College of Public Health, Kuwait University, Kuwait City, Kuwait
| | - Dari Alhuwail
- College of Life Sciences, Kuwait University, Kuwait City, Kuwait
| | - Syed Mohamed Aljunid
- Department of Health Policy and Management, College of Public Health, Kuwait University, Kuwait City, Kuwait
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Abed WH, Abu Shosha GM, Oweidat IA, Saleh RI, Nashwan AJ. Jordanian nurses' attitudes toward using electronic health records during COVID-19 pandemic. INFORMATICS IN MEDICINE UNLOCKED 2022; 34:101102. [PMID: 36213338 PMCID: PMC9531357 DOI: 10.1016/j.imu.2022.101102] [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: 09/01/2022] [Revised: 10/02/2022] [Accepted: 10/02/2022] [Indexed: 11/06/2022] Open
Abstract
Electronic health records (EHRs) have proven their effectiveness during the coronavirus disease (COVID-19) pandemic. However, successful implementation of EHRs requires assessing nurses' attitudes as they are considered the first line in providing direct care for patients. This study assessed Jordanian nurses' attitudes and examined factors that affect nurses' attitudes toward using EHRs. A cross-sectional, correlational design was used. A convenient sample of 130 nurses was recruited from three major public hospitals in Jordan. All Participants completed the Nurses' attitudes Towards Computerization (NATC) Questionnaire. The overall nurses' attitude was positive; the mean was 61.85 (SD = 10.97). Findings revealed no significant relationship between nurses' attitudes toward using EHRs and nurses’ age, gender, education level, previous computer skills experience, years of work experience, and years of dealing with EHRs. However, the work unit was found to have a significant correlation with nurses' attitudes toward using EHRs. Therefore, nurse administrators should arrange for the conduct of educational workshops and continuous training programs considering the needs of the nurses.
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Affiliation(s)
| | | | | | - Rafat I. Saleh
- General Hospital, King Saud Medical City, Riyadh, Saudi Arabia
| | - Abdulqadir J. Nashwan
- Nursing Department, Hamad Medical Corporation, Doha, Qatar,Corresponding author. P.O. Box 3050, Doha, Qatar
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Abstract
Understanding the factors affecting the use of healthcare technologies is a crucial topic that has been extensively studied, specifically during the last decade. These factors were studied using different technology acceptance models and theories. However, a systematic review that offers extensive understanding into what affects healthcare technologies and services and covers distinctive trends in large-scale research remains lacking. Therefore, this review aims to systematically review the articles published on technology acceptance in healthcare. From a yield of 1768 studies collected, 142 empirical studies have met the eligibility criteria and were extensively analyzed. The key findings confirmed that TAM and UTAUT are the most prevailing models in explaining what affects the acceptance of various healthcare technologies through different user groups, settings, and countries. Apart from the core constructs of TAM and UTAUT, the results showed that anxiety, computer self-efficacy, innovativeness, and trust are the most influential factors affecting various healthcare technologies. The results also revealed that Taiwan and the USA are leading the research of technology acceptance in healthcare, with a remarkable increase in studies focusing on telemedicine and electronic medical records solutions. This review is believed to enhance our understanding through a number of theoretical contributions and practical implications by unveiling the full potential of technology acceptance in healthcare and opening the door for further research opportunities.
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Ebnehoseini Z, Jangi M, Tara M, Tabesh H. Investigation the success rate of hospital information system (HIS): Development of a questionnaire and case study. J Healthc Qual Res 2021; 36:103-112. [PMID: 33495115 DOI: 10.1016/j.jhqr.2020.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Revised: 02/21/2020] [Accepted: 03/02/2020] [Indexed: 11/17/2022]
Abstract
INTRODUCTION AND OBJECTIVES The implantation of hospital information systems (HISs) has grown dramatically in recent years. Understanding the success rate of HIS is key in health organizations. In this study, a validated questionnaire for HISs evaluation based on the Information System Success Model (ISSM) has been provided. In addition, the HIS success rate was determined. MATERIALS AND METHODS The current study was conducted at one of the largest teaching hospitals in eastern Iran. The 44-items questionnaire was developed for data gathering. The questionnaire covered ISSM dimensions, which include analysis of quality system, quality of information, quality service, system use, usefulness, satisfaction, and net benefits. Content validity, constructs validity, and reliability of the ISSM questionnaire was measured. HIS success rate has been determined and categorized based on users' perspective as follows: appropriate (75%≤HIS success rate), moderate (50%≤HIS success rate<75%), low coverage (25%≤HIS success rate<50%), and poor (coverage rate<25%). RESULTS In total, 253 users participated in the study. The ISSM questionnaire was validated by an expert panel with CVI: 85.12% and CVR: 88.22%. The overall Cronbach's alpha value of the instrument was determined as 92.2%. Nine factors with eigenvalues greater than 1.00 were identified, jointly accounting for 66.91% of the total variance. The value of KMO was.866 showed that the sample size was adequate for factor analysis. The highly significant Bartlett's test (p<0.000) indicated that variables were correlated and the factor analysis was appropriate. Our results demonstrated that the total mean of HIS success was "moderate" base on the users' point of view. CONCLUSIONS The findings of the current study, provide valuable scientific evidence for key affecting factors on hospital EHR in Iran as a developing country.
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Affiliation(s)
- Z Ebnehoseini
- Medical Informatics, Psychiatry and Behavioral Sciences Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - M Jangi
- Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - M Tara
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - H Tabesh
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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Barnett SD, Desai D, Davis T, Hawksworth L, Keeling E, Drake J, Cudjoe J. Development and Psychometric Testing of the Remote Visual Monitoring Acceptance Tool. J Nurs Meas 2020; 28:439-454. [PMID: 33199480 DOI: 10.1891/jnm-d-19-00092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND PURPOSE Using remote visual monitoring (RVM) technology to observe patients at high risk for falls can effectively reduce falls and sitter costs. However, RVM is underutilized by direct care nurses. This study describes the development and testing of a new tool to measure nurses' acceptance of RVM technology. METHODS The RVM Acceptance Tool (RVMAT) was tested among nurses recruited from a large health system. RESULTS Three factors accounted for 70.38% of the total variance: Value, Patient Selection, and Availability and Intent to Use. The overall 25-item scale had good internal consistency (Cronbach's alpha = .98). CONCLUSION The RVMAT is a theoretically grounded, valid, and reliable tool. Further research is needed to test its use in predicting nurses' acceptance and intent to incorporate new technology into daily nursing care.
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Affiliation(s)
| | | | | | | | - Eva Keeling
- Inova Alexandria Hospital, Alexandria, Virginia
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Willingness to Use Electronic Medical Record (EMR) System in Healthcare Facilities of Bahir Dar City, Northwest Ethiopia. BIOMED RESEARCH INTERNATIONAL 2020; 2020:3827328. [PMID: 32908886 PMCID: PMC7471823 DOI: 10.1155/2020/3827328] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 07/25/2020] [Accepted: 08/03/2020] [Indexed: 11/17/2022]
Abstract
Background Globally, electronic information and communication technology has been applied and much expanded in the healthcare industry. However, in developing counties including Ethiopia, EMR system adoption and utilization for medical practice are still inconsistent, and healthcare institutions which started utilization currently have also failed to sustain. A desirable readiness of healthcare experts is mandatory to expand digital health service delivery. Thus, this study is aimed at estimating the proportion of the willingness of professionals in Bahir Dar city to use EMR and at identifying factors associated with this proportion. Methods An institution-based cross-sectional study was conducted from September 1 to October 30, 2019, among 634 health professionals. Respondents were selected using a simple random sampling method. Data were entered into EpiData version 3.1 and exported to SPSS version 23 for further analysis. Descriptive statistics were computed to describe study variables and presented using tables. Willingness to use the EMR system was computed. Bivariable and multivariable binary logistic regression models were fitted to identify the associated factors. The odds ratio with 95% confidence interval was used to measure the strength of association. Results A total of 616 health professionals participated in the study with a response rate of 97%. The proportion of willingness to use the EMR system was 85.9%. Among health professionals who were not willing to use EMR, lack of access to EMR training (73.4%) was a major barrier to the willingness to use EMR. A multivariable logistic regression analysis showed that those health professionals who had good computer skill (AOR = 2.5; 95% CI: 1.3-4.6), good knowledge on EMR (AOR = 2.1; 95% CI: 1-4.4), gotten EMR training (AOR = 3.8; 95% CI: 1.7-8.1), EMR guideline access (AOR = 2.8; 95% CI: 1.4-5.6), and management support (AOR = 2.6; 95% CI: 1.4-4.8) were more likely willing to use the EMR system. Conclusions Majority of the professionals were willing to use the EMR system. EMR program should involve computer illiterate, less knowledgeable, those unable to access EMR guidelines, and managerially unsupported professionals. Enhancing health professionals' attitude and contextualizing EMR training in the healthcare curricula are highly recommended to scale up EMR use.
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Ferdousi R, Arab-Zozani M, Tahamtan I, Rezaei-Hachesu P, Dehghani M. Attitudes of nurses towards clinical information systems: a systematic review and meta-analysis. Int Nurs Rev 2020; 68:59-66. [PMID: 32608032 DOI: 10.1111/inr.12603] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 05/15/2020] [Accepted: 05/19/2020] [Indexed: 01/29/2023]
Abstract
AIM This systematic review and meta-analysis evaluates the attitudes of Iranian nurses towards clinical information systems in nursing practice. BACKGROUND Nurses are essential in the successful adoption and implementation of clinical information systems. METHODS A systematic search was performed in Medline, Embase, Cochrane, CINAHL, Scopus, and Web of Science and Farsi databases, to retrieve relevant studies. The methodological quality of the studies is assessed via the Joanna Briggs Institute's critical appraisal checklist for analytical cross-sectional studies. The random effect model was utilized to analyse the data due to the high heterogeneity in the included studies (n = 17). RESULTS Results indicate that clinical information systems impact on at least seven aspects of nursing practice, including documentation, patient safety, quality of treatment, communication, treatment management, nursing tasks and hospital resource management. Results also indicated that one aspect of using clinical information systems in nursing practice is satisfaction with the 'quality and design of clinical information systems', such as ease of use and learning, flexibility and software speed. CONCLUSION Clinical information systems can contribute to different aspects of nursing practice. However, their design should improve significantly in order to help nurses perform their professional activities in an efficient and satisfactory manner. IMPLICATIONS FOR NURSING POLICY Before the full deployment of clinical information systems, their usability should be tested. In pilot testing, nurses should provide necessary feedback about how well the systems work and improvements needed to meet their professional goals.
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Affiliation(s)
- R Ferdousi
- School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - M Arab-Zozani
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - I Tahamtan
- College of Communication and Information, University of Tennessee, Knoxville, TN, USA
| | - P Rezaei-Hachesu
- School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - M Dehghani
- Scientific and Educational Center for Health Management of Iran & Student Research Committee, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
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Alumran A, Alkhaldi O, Aldroorah Z, Alsayegh Z, Alsafwani F, Almaghraby N. Utilization of an Electronic Triage System by Emergency Department Nurses. J Multidiscip Healthc 2020; 13:339-344. [PMID: 32280235 PMCID: PMC7128074 DOI: 10.2147/jmdh.s250962] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 03/20/2020] [Indexed: 11/30/2022] Open
Abstract
Introduction Emergency departments use triage systems to prioritize patients according to the severity of their condition. The Electronic Canadian Triage and Acuity Scale (E-CTAS) is a popular system that categorizes patients into five levels to manage patient flow and prioritize patient access to health-care services. Methods We assessed the factors that influence E-CTAS usage in emergency departments in Eastern Saudi Arabia. Seventy-one nurses were included from two emergency departments that adopted E-CTAS. We used the technology acceptance model (TAM) to assess the influencing factors. The TAM was reliable in the study setting (Cronbach’s α = 0.87). Results All of the TAM domains were significantly related to the usage of E-CTAS: perceived ease of use, perceived usefulness, importance of training, social influence, behavior intention, and attitude. We also showed that E-CTAS use significantly increased with years of experience and training. Discussion Many factors influenced the use of this electronic triage system. Focusing on these factors in future electronic triage system implementations might increase the hospital staff’s compliance, thus improving accuracy and better organizing the patient flow in emergency departments.
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Affiliation(s)
- Arwa Alumran
- Health Information Management and Technology Department, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Ohoud Alkhaldi
- Health Information Management and Technology Department, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Zainab Aldroorah
- Health Information Management and Technology Department, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Zainab Alsayegh
- Health Information Management and Technology Department, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Fatimah Alsafwani
- Health Information Management and Technology Department, College of Public Health, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Nisreen Almaghraby
- Emergency Department, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Feldman SS, Bhavsar GP, Schooley BL. Consumer perceptions of health IT utilization and benefits. JAMIA Open 2020; 2:99-106. [PMID: 31984349 PMCID: PMC6951931 DOI: 10.1093/jamiaopen/ooy049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 05/25/2018] [Accepted: 11/06/2018] [Indexed: 12/02/2022] Open
Abstract
Objectives The objective of this article is to examine consumer perceptions of health information technology (health IT) utilization and benefits through an integrated conceptual framework. Materials and Methods This article employs an integrated conceptual framework to examine consumer perceptions of health IT. A consumer survey yielded 1125 completed responses. A factor-based scale was developed for each sub-construct. Bivariate analysis using χ2 tests was performed to determine differences in the percentage of respondents who agreed with each sub-construct based on whether their physician used an electronic health record (EHR) system. Multivariable logistic regression that controlled for demographic characteristics of respondents was performed to determine adjusted odds of agreeing with selected opinions of health information exchange (HIE). Results Results indicate that respondents whose physicians used an EHR system were significantly more likely to agree that there was a perceived benefit with HIE and to care provided; that the patient should have control over the record; that they trust the physician and security of the medical information; that they understand the need for HIE, and that HIE must be easy to use. Discussion The results suggest that consumers who have experienced the use of one technology in the healthcare setting can recognize the potential benefit of another technology. Race/ethnicity, gender, and education played some role in respondents’ views of EHRs and HIE, more specifically, non-Hispanic African American participants indicated lower levels of trust in HIE when compared with non-Hispanic Whites. Conclusion This cross-sectional survey indicated that physician use of EHRs significantly increases the odds of consumers’ seeing perceived benefits of HIE and understanding the need for HIE.
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Affiliation(s)
- Sue S Feldman
- Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Grishma P Bhavsar
- Department of Health Sciences, California State University, Northridge, Northridge, California, USA
| | - Benjamin L Schooley
- Department of Integrated Information Technology, University of South Carolina, Columbia, M. Bert Storey Innovation Center, Columbia, South Carolina, USA
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