1
|
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.
Collapse
Affiliation(s)
| | - Fatoş Korkmaz
- Faculty of Nursing, Hacettepe University, Ankara, Turkey
| |
Collapse
|
2
|
Jabeen S, Rahman M, Siddique AB, Hasan M, Matin R, Rahman QSU, AKM TH, Alim A, Nadia N, Mahmud M, Islam J, Islam MS, Haider MS, Dewan F, Begum F, Barua U, Anam MT, Islam A, Razzak KSB, Ameen S, Hossain AT, Nahar Q, Ahmed A, El Arifeen S, Rahman AE. Introducing a digital emergency obstetric and newborn care register for indoor obstetric patient management: An implementation research in selected public health care facilities of Bangladesh. J Glob Health 2024; 14:04075. [PMID: 38722093 PMCID: PMC11082830 DOI: 10.7189/jogh.14.04075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2024] Open
Abstract
Background Digital health records have emerged as vital tools for improving health care delivery and patient data management. Acknowledging the gaps in data recording by a paper-based register, the emergency obstetric and newborn care (EmONC) register used in the labour ward was digitised. In this study, we aimed to assess the implementation outcome of the digital register in selected public health care facilities in Bangladesh. Methods Extensive collaboration with stakeholders facilitated the development of an android-based electronic register from the paper-based register in the labour rooms of the selected district and sub-district level public health facilities of Bangladesh. We conducted a study to assess the implementation outcome of introducing the digital EmONC register in the labour ward. Results The digital register demonstrated high usability with a score of 83.7 according to the system usability scale, and health care providers found it highly acceptable, with an average score exceeding 95% using the technology acceptance model. The adoption rate reached an impressive 98% (95% confidence interval (CI) = 98-99), and fidelity stood at 90% (95% CI = 88-91) in the digital register, encompassing more than 80% of data elements. Notably, fidelity increased significantly over the implementation period of six months. The digital system proved a high utility rate of 89% (95% CI = 88-91), and all outcome variables exceeded the predefined benchmark. Conclusions The implementation outcome assessment underscores the potential of the digital register to enhance maternal and newborn health care in Bangladesh. Its user-friendliness, improved data completeness, and high adoption rates indicate its capacity to streamline health care data management and improve the quality of care.
Collapse
Affiliation(s)
- Sabrina Jabeen
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Mahiur Rahman
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | - Mehedi Hasan
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Rubaiya Matin
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | | | - Azizul Alim
- Directorate General of Health Services, Ministry of Health and Family Welfare, Government of the People’s Republic of Bangladesh, Dhaka, Bangladesh
| | - Nuzhat Nadia
- Directorate General of Health Services, Ministry of Health and Family Welfare, Government of the People’s Republic of Bangladesh, Dhaka, Bangladesh
| | - Mustufa Mahmud
- Directorate General of Health Services, Ministry of Health and Family Welfare, Government of the People’s Republic of Bangladesh, Dhaka, Bangladesh
| | - Jahurul Islam
- Directorate General of Health Services, Ministry of Health and Family Welfare, Government of the People’s Republic of Bangladesh, Dhaka, Bangladesh
| | - Muhammad Shariful Islam
- Directorate General of Health Services, Ministry of Health and Family Welfare, Government of the People’s Republic of Bangladesh, Dhaka, Bangladesh
| | - Mohammad Sabbir Haider
- Directorate General of Health Services, Ministry of Health and Family Welfare, Government of the People’s Republic of Bangladesh, Dhaka, Bangladesh
| | - Farhana Dewan
- Obstetrical and Gynaecological Society of Bangladesh, Dhaka, Bangladesh
| | - Ferdousi Begum
- Obstetrical and Gynaecological Society of Bangladesh, Dhaka, Bangladesh
| | - Uchchash Barua
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | - Abirul Islam
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | - Shafiqul Ameen
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | | - Quamrun Nahar
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Anisuddin Ahmed
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Shams El Arifeen
- International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | | |
Collapse
|
3
|
Brady AM, Fortune J, Ali AH, Prizeman G, To WT, Courtney G, Stokes K, Roche M. Multidisciplinary user experience of a newly implemented electronic patient record in Ireland: An exploratory qualitative study. Int J Med Inform 2024; 185:105399. [PMID: 38430733 DOI: 10.1016/j.ijmedinf.2024.105399] [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: 11/20/2023] [Revised: 02/16/2024] [Accepted: 02/27/2024] [Indexed: 03/05/2024]
Abstract
BACKGROUND Implementation of an Electronic Patient Record (EPR) in a key milestone in the digital strategy of modern healthcare organisations. The implementation of EPR systems can be viewed as challenging and complex. OBJECTIVE The aim of the study was to investigate user perspectives and experiences of the implementation of an Electronic Medical Record in a major academic teaching hospital, with simultaneous 'go-live' across the whole hospital taking place. METHODS Focus groups and individual in-depth interviews were conducted with stakeholders and users (n = 105), approximately nine months post-EPR implementation. The study explored EPR users' perceptions using an extended theoretical framework of the DeLone and McLean Information Systems Success Model (2003), which measured information systems, system quality, information quality, service quality, use/perceived usefulness & user satisfaction and net benefits. RESULTS Staff engagement and satisfaction was high and the EPR is accepted as the new standard way of completing care. There was agreement that the EPR affords transparency, and greater accountability. There was some concern expressed regarding impact of the EPR on interprofessional and patient/provider interactions and communication. Physicians reported the inputting of social history through free text as an issue of concern and time consuming. The Big Bang approach with mandatory conversion was key to the successful adoption of EPR. There was consensus across professional and administrative respondents that there was no appetite to return to paper-based records. CONCLUSION The successful roll out of the EPR reflects the digital readiness of healthcare providers and organisations. The potential for unintended consequences on work process requires continual monitoring. A key future benefit of the EPR will be the capacity to reach a broader understanding and analysis of variation in processes and outcomes within healthcare organisations. It is clear that skills in data analytics will be needed to mine data successfully.
Collapse
Affiliation(s)
- Anne-Marie Brady
- Trinity Centre Practice & Healthcare Innovation, School of Nursing and Midwifery, Trinity College Dublin, 24, D'olier St, Dublin 2, Ireland.
| | - Jennifer Fortune
- Trinity Centre Practice & Healthcare Innovation, School of Nursing and Midwifery, Trinity College Dublin, 24, D'olier St, Dublin 2, Ireland
| | - Ahmed Hassan Ali
- Trinity Centre Practice & Healthcare Innovation, School of Nursing and Midwifery, Trinity College Dublin, 24, D'olier St, Dublin 2, Ireland
| | - Geraldine Prizeman
- Trinity Centre Practice & Healthcare Innovation, School of Nursing and Midwifery, Trinity College Dublin, 24, D'olier St, Dublin 2, Ireland
| | - Wing Ting To
- Trinity Centre Practice & Healthcare Innovation, School of Nursing and Midwifery, Trinity College Dublin, 24, D'olier St, Dublin 2, Ireland
| | | | | | | |
Collapse
|
4
|
Naamneh R, Bodas M. The effect of electronic medical records on medication errors, workload, and medical information availability among qualified nurses in Israel- a cross sectional study. BMC Nurs 2024; 23:270. [PMID: 38658976 PMCID: PMC11044371 DOI: 10.1186/s12912-024-01936-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 04/12/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Errors in medication administration by qualified nursing staff in hospitals are a significant risk factor for patient safety. In recent decades, electronic medical records (EMR) systems have been implemented in hospitals, and it has been claimed that they contribute to reducing such errors. However, systematic research on the subject in Israel is scarce. This study examines the position of the qualified nursing staff regarding the impact of electronic medical records systems on factors related to patient safety, including errors in medication administration, workload, and availability of medical information. METHODS This cross-sectional study examines three main variables: Medication errors, workload, and medical information availability, comparing two periods- before and after EMR implementation based on self-reports. A final sample of 591 Israeli nurses was recruited using online private social media groups to complete an online structured questionnaire. The questionnaires included items assessing workload (using the Expanding Nursing Stress Scale), medical information availability (the Carrington-Gephart Unintended Consequences of Electronic Health Record Questionnaire), and medical errors (the Medical Error Checklists). Items were assessed twice, once for the period before the introduction of electronic records and once after. In addition, participants answered open-ended questions that were qualitatively analyzed. RESULTS Nurses perceive the EMR as reducing the extent of errors in drug administration (mean difference = -0.92 ± 0.90SD, p < 0.001), as well as the workload (mean difference = -0.83 ± 1.03SD, p < 0.001) by ∼ 30% on average, each. Concurrently, the systems are perceived to require a longer documentation time at the expense of patients' treatment time, and they may impair the availability of medical information by about 10% on average. CONCLUSION The results point to nurses' perceived importance of EMR systems in reducing medication errors and relieving the workload. Despite the overall positive attitudes toward EMR systems, nurses also report that they reduce information availability compared to the previous pen-and-paper approach. A need arises to improve the systems in terms of planning and adaptation to the field and provide appropriate technical and educational support to nurses using them.
Collapse
Affiliation(s)
- Raneen Naamneh
- Department of Emergency & Disaster Management, School of Public Health, Faculty of Medical and Health Sciences, Tel-Aviv University, 39040, Tel-Aviv-Yafo, Israel
| | - Moran Bodas
- Department of Emergency & Disaster Management, School of Public Health, Faculty of Medical and Health Sciences, Tel-Aviv University, 39040, Tel-Aviv-Yafo, Israel.
| |
Collapse
|
5
|
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 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.
Collapse
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
| |
Collapse
|
6
|
Litvinova O, Matin FB, Matin M, Zima-Kulisiewicz B, Tomasik C, Siddiquea BN, Stoyanov J, Atanasov AG, Willschke H. Patient safety discourse in a pandemic: a Twitter hashtag analysis study on #PatientSafety. Front Public Health 2023; 11:1268730. [PMID: 38035302 PMCID: PMC10687459 DOI: 10.3389/fpubh.2023.1268730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 10/27/2023] [Indexed: 12/02/2023] Open
Abstract
Background The digitalization of medicine is becoming a transformative force in modern healthcare systems. This study aims to investigate discussions regarding patient safety, as well as summarize perceived approaches to mitigating risks of adverse events expressed through the #PatientSafety Twitter hashtag during the COVID-19 pandemic. Methods This research is grounded in the analysis of data extracted from Twitter under the hashtag #PatientSafety between December 1, 2019 and February 1, 2023. Symplur Signals, which represents a tool offering a method to monitor tweets containing hashtags registered with the Symplur Healthcare Hashtag Project, was used for analyzing the tweets shared in the study period. For text analytics of the relevant data, we further used the word cloud generator MonkeyLearn, and VOSviewer. Results The analysis encompasses 358'809 tweets that were shared by 90'079 Twitter users, generating a total of 1'183'384'757 impressions. Physicians contributed to 18.65% of all tweets, followed by other healthcare professionals (14.31%), and health-focused individuals (10.91%). Geographically, more than a third of tweets (60.90%) were published in the United States. Canada and India followed in second and third positions, respectively. Blocks of trending terms of greater interest to the global Twitter community within the hashtag #PatientSafety were determined to be: "Patient," "Practical doctors," and "Health Care Safety Management." The findings demonstrate the engagement of the Twitter community with COVID-19 and problems related to the training, experience of doctors and patients during a pandemic, communication, the vaccine safety and effectiveness, and potential use of off-label drugs. Noteworthy, in the field of pharmacovigilance, Twitter has the possibility of identifying adverse reactions associated with the use of drugs, including vaccines. The issue of medical errors has been also discussed by Twitter users using the hashtag #PatientSafety. Conclusion It is clear that various stakeholders, including students, medical practitioners, health organizations, pharmaceutical companies, and regulatory bodies, leverage Twitter to rapidly exchange medical information, data on the disease symptoms, and the drug effects. Consequently, there is a need to further integrate Twitter-derived data into the operational routines of healthcare organizations.
Collapse
Affiliation(s)
- Olena Litvinova
- Department of Management and Quality Assurance in Pharmacy, National University of Pharmacy of the Ministry of Health of Ukraine, Kharkiv, Ukraine
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria
| | - Farhan Bin Matin
- Department of Pharmacy, East West University, Aftabnagar, Dhaka, Bangladesh
| | - Maima Matin
- Institute of Genetics and Animal Biotechnology of the Polish Academy of Sciences, Jastrzebiec, Poland
| | - Bogumila Zima-Kulisiewicz
- Institute of Genetics and Animal Biotechnology of the Polish Academy of Sciences, Jastrzebiec, Poland
| | - Cyprian Tomasik
- Institute of Genetics and Animal Biotechnology of the Polish Academy of Sciences, Jastrzebiec, Poland
| | - Bodrun Naher Siddiquea
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | | | - Atanas G. Atanasov
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria
- Institute of Genetics and Animal Biotechnology of the Polish Academy of Sciences, Jastrzebiec, Poland
| | - Harald Willschke
- Ludwig Boltzmann Institute Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria
- Department of Anaesthesia, Intensive Care Medicine and Pain Medicine, Medical University Vienna, Vienna, Austria
| |
Collapse
|
7
|
El Yaman N, Zeitoun J, Diab R, Mdaihly M, Diab R, Kobeissi L, Abou Ljoud S, Antoun J, Bardus M. Utilization of patient portals: a cross-sectional study investigating associations with mobile app quality. BMC Med Inform Decis Mak 2023; 23:177. [PMID: 37670277 PMCID: PMC10481578 DOI: 10.1186/s12911-023-02252-x] [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: 01/25/2023] [Accepted: 07/28/2023] [Indexed: 09/07/2023] Open
Abstract
BACKGROUND Mobile apps facilitate patients' access to portals and interaction with their healthcare providers. The COVID-19 pandemic accelerated this trend globally, but little evidence exists on patient portal usage in the Middle East, where internet access and digital literacy are limited. Our study aimed to explore how users utilize a patient portal through its related mobile app (MyChart by EPIC). METHODS We conducted a cross-sectional survey of MyChart users, recruited from a tertiary care center in Lebanon. We collected MyChart usage patterns, perceived outcomes, and app quality, based on the Mobile Application Rating Scale (user version, uMARS), and sociodemographic factors. We examined associations between app usage, app quality, and sociodemographic factors using Pearson's correlations, Chi-square, ANOVA, and t-tests. RESULTS 428 users completed the survey; they were primarily female (63%), aged 41.3 ± 15.6 years, with a higher education level (87%) and a relatively high crowding index of 1.4 ± 0.6. Most of the sample was in good and very good health (78%) and had no chronic illnesses (67%), and accessed the portal through MyChart once a month or less (76%). The most frequently used features were accessing health records (98%), scheduling appointments (67%), and messaging physicians (56%). According to uMARS completers (n = 200), the objective quality score was 3.8 ± 0.5, and the subjective quality was 3.6 ± 0.7. No significant association was found between overall app usage and the mobile app quality measured via uMARS. Moreover, app use frequency was negatively associated with education, socioeconomic status, and perceived health status. On the other hand, app use was positively related to having chronic conditions, the number of physician visits and subjective app quality. CONCLUSION The patient portal usage was not associated with app quality but with some of the participants' demographic factors. The app offers a user-friendly, good-quality interface to patient health records and physicians, appreciated chiefly by users with relatively low socioeconomic status and education. While this is encouraging, more research is needed to capture the usage patterns and perceptions of male patients and those with even lower education and socioeconomic status, to make patient portals more inclusive.
Collapse
Affiliation(s)
- Noha El Yaman
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Jad Zeitoun
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Rawan Diab
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Mohamad Mdaihly
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Razan Diab
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Lynn Kobeissi
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Salwa Abou Ljoud
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Jumana Antoun
- Department of Family Medicine, Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
| | - Marco Bardus
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, B15 2TT, UK.
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
| |
Collapse
|
8
|
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.
Collapse
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;
| |
Collapse
|
9
|
Aldughayfiq B, Ashfaq F, Jhanjhi NZ, Humayun M. Capturing Semantic Relationships in Electronic Health Records Using Knowledge Graphs: An Implementation Using MIMIC III Dataset and GraphDB. Healthcare (Basel) 2023; 11:1762. [PMID: 37372880 DOI: 10.3390/healthcare11121762] [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: 05/14/2023] [Revised: 06/03/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
Electronic health records (EHRs) are an increasingly important source of information for healthcare professionals and researchers. However, EHRs are often fragmented, unstructured, and difficult to analyze due to the heterogeneity of the data sources and the sheer volume of information. Knowledge graphs have emerged as a powerful tool for capturing and representing complex relationships within large datasets. In this study, we explore the use of knowledge graphs to capture and represent complex relationships within EHRs. Specifically, we address the following research question: Can a knowledge graph created using the MIMIC III dataset and GraphDB effectively capture semantic relationships within EHRs and enable more efficient and accurate data analysis? We map the MIMIC III dataset to an ontology using text refinement and Protege; then, we create a knowledge graph using GraphDB and use SPARQL queries to retrieve and analyze information from the graph. Our results demonstrate that knowledge graphs can effectively capture semantic relationships within EHRs, enabling more efficient and accurate data analysis. We provide examples of how our implementation can be used to analyze patient outcomes and identify potential risk factors. Our results demonstrate that knowledge graphs are an effective tool for capturing semantic relationships within EHRs, enabling a more efficient and accurate data analysis. Our implementation provides valuable insights into patient outcomes and potential risk factors, contributing to the growing body of literature on the use of knowledge graphs in healthcare. In particular, our study highlights the potential of knowledge graphs to support decision-making and improve patient outcomes by enabling a more comprehensive and holistic analysis of EHR data. Overall, our research contributes to a better understanding of the value of knowledge graphs in healthcare and lays the foundation for further research in this area.
Collapse
Affiliation(s)
- Bader Aldughayfiq
- Department of Information Systems, College of Computer and Information Sciences, Jouf University, Sakaka 72388, Saudi Arabia
| | - Farzeen Ashfaq
- School of Computer Science-SCS, Taylor's University, Subang Jaya 47500, Malaysia
| | - N Z Jhanjhi
- School of Computer Science-SCS, Taylor's University, Subang Jaya 47500, Malaysia
| | - Mamoona Humayun
- Department of Information Systems, College of Computer and Information Sciences, Jouf University, Sakaka 72388, Saudi Arabia
| |
Collapse
|
10
|
Lei KC, Loi CI, Cen Z, Li J, Liang Z, Hu H, Chan TF, Ung COL. Adopting an electronic medication administration system in long-term care facilities: a key stakeholder interview study in Macao. Inform Health Soc Care 2023:1-15. [PMID: 36650719 DOI: 10.1080/17538157.2023.2165084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
To improve medication safety for residents in long-term care facilities (LTCFs), electronic medication administration records (eMARs) are widely adopted in Macao. This study aimed to (1) develop a logic model for adopting eMAR in LTCFs and (2) explore the contextual factors relevant to the implementation. Semi-structured interviews were conducted with key stakeholders (managers, doctors, nurses, pharmacy staff and other frontline workers) experienced with eMAR in LTCFs in Macao between February and March 2021. Purposive sampling was used for recruitment and thematic analysis followed the theoretical framework of the logic model. All 57 participants were positive about eMAR. Financial and nonfinancial resources were critical to adopting eMAR. eMAR was mostly used for its functions in documentation, e-prescribing and monitoring. Immediate output included simplified working process, reduced errors, closer monitoring of residents' conditions, and timely communication among staff. The outcomes mainly related to efficiency, safety and quality of care, workload redundancy, and data unification. Key influencing factors included eMAR flexibility, stability, and technical support. Adopting eMARs is highly consuming and the benefits in improving quality of care can only be realized with appropriate implementation, precise execution, regular evaluation and responsive adjustment. The proposed logic model framework serves as a roadmap for LTCFs, both current and future users of eMAR.
Collapse
Affiliation(s)
- Ka Cheng Lei
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao, SAR, China
| | - Cheng I Loi
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao, SAR, China
| | - Zhifeng Cen
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao, SAR, China
| | - Junlei Li
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao, SAR, China
| | - Zuanji Liang
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao, SAR, China
| | - Hao Hu
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao, SAR, China.,Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macao, SAR, China
| | - Tek Fai Chan
- Macao Society for Medicinal Administration, Macao, SAR, China
| | - Carolina Oi Lam Ung
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao, SAR, China.,Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macao, SAR, China
| |
Collapse
|
11
|
Kim OT. Patient safety as a global health priority. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2022. [DOI: 10.15829/1728-8800-2022-3427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Patient safety is a discipline that has arisen in response to the increasing complexity of health care delivery and the associated increase in patient harm. Adverse health care events are a serious problem, causing significant harm to the patient and increasing health care costs. The World Health Organization has identified patient safety as one of the key priorities for world health. The current review presents the historical background that led to the formation of the discipline of patient safety, the determinants of adverse events in medical practice, and the main tools for dealing with them.
Collapse
Affiliation(s)
- O. T. Kim
- National Medical Research Center for Therapy and Preventive Medicine
| |
Collapse
|
12
|
von Gerich H, Moen H, Peltonen L. Identifying nursing sensitive indicators from electronic health records in acute cardiac care-Towards intelligent automated assessment of care quality. J Nurs Manag 2022; 30:3726-3735. [PMID: 36124426 PMCID: PMC10086830 DOI: 10.1111/jonm.13802] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/24/2022] [Accepted: 09/14/2022] [Indexed: 12/30/2022]
Abstract
AIM The aim of this study is to explore the potential of using electronic health records for assessment of nursing care quality through nursing-sensitive indicators in acute cardiac care. BACKGROUND Nursing care quality is a multifaceted phenomenon, making a holistic assessment of it difficult. Quality assessment systems in acute cardiac care units could benefit from big data-based solutions that automatically extract and help interpret data from electronic health records. METHODS This is a deductive descriptive study that followed the theory of value-added analysis. A random sample from electronic health records of 230 patients was analysed for selected indicators. The data included documentation in structured and free-text format. RESULTS One thousand six hundred seventy-six expressions were extracted and divided into (1) established and (2) unestablished expressions, providing positive, neutral and negative descriptions related to care quality. CONCLUSIONS Electronic health records provide a potential source of information for information systems to support assessment of care quality. More research is warranted to develop, test and evaluate the effectiveness of such tools in practice. IMPLICATIONS FOR NURSING MANAGEMENT Knowledge-based health care management would benefit from the development and implementation of advanced information systems, which use continuously generated already available real-time big data for improved data access and interpretation to better support nursing management in quality assessment.
Collapse
Affiliation(s)
- Hanna von Gerich
- Turku University Hospital, Department of Nursing ScienceUniversity of TurkuTurkuFinland
| | - Hans Moen
- Department of Computer ScienceAalto UniversityEspooFinland
| | | |
Collapse
|
13
|
Attafuah PYA, Abor PA, Abuosi AA, Nketiah-Amponsah E, Tenza IS. Satisfied or not satisfied? Electronic health records system implementation in Ghana: Health leaders' perspective. BMC Med Inform Decis Mak 2022; 22:249. [PMID: 36138402 PMCID: PMC9494885 DOI: 10.1186/s12911-022-01998-0] [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: 05/29/2022] [Accepted: 09/16/2022] [Indexed: 11/13/2022] Open
Abstract
Background Electronic Health Records (EHR) has been espoused to be an innovation from the paper-based system, with benefits such as fast access to patient information thereby facilitating healthcare provider communication, healthcare continuity and improved quality of care. However, it is the extent of the quality of the electronic health records that determines the access to these stated benefits. The quality of health care records indirectly contributes to patient safety because inaccurate patient data can lead to improper diagnosis and consequently wrong treatment of patients. Most hospitals in Ghana, have recently transitioned into the EHR system, hence, there is a need to assess its accuracy, impact on workflow, staff training on usage, support from the EHR team, and the overall satisfaction of the EHR system. As health leaders are at the frontline of its implementation, their views on the challenges and successes of the EHR system are imperative. Method This qualitative study sought to explore the views of the health leaders on the implemented electronic health records system in nine (9) hospitals within three (3) regions in Ghana. Following ethical approval, GHS-ERC:007/04/21, focus group discussions were conducted with a minimum of 10 hospital leaders in each facility. These included quasi, government and private hospitals. Data was collected between September and November 2021. Results The study found poor quality of records, lack of involvement of frontline clinicians in the development of the EHR system, inadequate training of staff and limited workstations as some of the challenges associated with the use of EHR in hospitals. Health leaders were generally not satisfied with the EHR system. Conclusion It is recommended that addressing inputs from end-users as well as circulating more computers will motivate EHR usage and acceptance. Provision of additional workstations for the various units and involvement of staff in the system development would be most prudent to enable health workers to accept the EHR system in improving the quality of care.
Collapse
Affiliation(s)
- Priscilla Y A Attafuah
- Public Health Nursing Department, School of Nursing and Midwifery, University of Ghana, Legon, Ghana
| | - Patience Aseweh Abor
- Department of Public Admin and Health Services Management, University of Ghana Business School, Legon, Ghana
| | - Aaron Asibi Abuosi
- Department of Public Admin and Health Services Management, University of Ghana Business School, Legon, Ghana.
| | | | - Immaculate Sabelile Tenza
- School of Nursing Science, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa.,School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
14
|
Wieduwilt F, Grünewald J, Ctistis G, Lenth C, Perl T, Wackerbarth H. Exploration of an Alarm Sensor to Detect Infusion Failure Administered by Syringe Pumps. Diagnostics (Basel) 2022; 12:diagnostics12040936. [PMID: 35453984 PMCID: PMC9032832 DOI: 10.3390/diagnostics12040936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/05/2022] [Accepted: 04/06/2022] [Indexed: 02/05/2023] Open
Abstract
Incorrect medication administration causes millions of undesirable complications worldwide every year. The problem is severe and there are many control systems in the market, yet the exact molecular composition of the solution is not monitored. Here, we propose an alarm sensor based on UV-Vis spectroscopy and refractometry. Both methods are non-invasive and non-destructive as they utilize visible light for the analysis. Moreover, they can be used for on-site or point-of-care diagnosis. UV-Vis-spectrometer detect the absorption of light caused by an electronic transition in an atom or molecule. In contrast a refractometer measures the extent of light refraction as part of a refractive index of transparent substances. Both methods can be used for quantification of dissolved analytes in transparent substances. We show that a sensor combining both methods is capable to discern most standard medications that are used in intensive care medicine. Furthermore, an integration of the alarm sensor in already existing monitoring systems is possible.
Collapse
Affiliation(s)
- Florian Wieduwilt
- Institut für Nanophotonik Göttingen e.V., Hans-Adolf-Krebs-Weg 1, 37077 Göttingen, Germany; (J.G.); (C.L.); (H.W.)
- Physical Chemistry of Nanomaterials, Institute of Chemistry and Center for Interdisciplinary Nanostructure Science and Technology (CINSaT), University of Kassel, Heinrich-Plett-Straße 40, 34132 Kassel, Germany
- Correspondence: (F.W.); (G.C.)
| | - Jasmin Grünewald
- Institut für Nanophotonik Göttingen e.V., Hans-Adolf-Krebs-Weg 1, 37077 Göttingen, Germany; (J.G.); (C.L.); (H.W.)
| | - Georgios Ctistis
- Institut für Nanophotonik Göttingen e.V., Hans-Adolf-Krebs-Weg 1, 37077 Göttingen, Germany; (J.G.); (C.L.); (H.W.)
- Correspondence: (F.W.); (G.C.)
| | - Christoph Lenth
- Institut für Nanophotonik Göttingen e.V., Hans-Adolf-Krebs-Weg 1, 37077 Göttingen, Germany; (J.G.); (C.L.); (H.W.)
| | - Thorsten Perl
- Department of General, Visceral and Pediatric Surgery, University Medical Center Göttingen, Robert-Koch-Straße 40, 37075 Göttingen, Germany;
| | - Hainer Wackerbarth
- Institut für Nanophotonik Göttingen e.V., Hans-Adolf-Krebs-Weg 1, 37077 Göttingen, Germany; (J.G.); (C.L.); (H.W.)
| |
Collapse
|
15
|
Wynter K, Holton S, Nguyen L, Sinnott H, Wickramasinghe N, Crowe S, Rasmussen B. Nurses. AUST HEALTH REV 2021; 46:188-196. [PMID: 34454640 DOI: 10.1071/ah21118] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 05/28/2021] [Indexed: 11/23/2022]
Abstract
ObjectiveThe aim of this study was to describe nurses' and midwives' experiences following the first phase of the implementation of an electronic medical record (EMR) system at a large public health service in metropolitan Melbourne, Australia.MethodsFour focus groups were held 8-10 months after implementation of the EMR. Transcripts were analysed using thematic analysis.ResultsOf 39 participants, 25 were nurses (64%), 12 were midwives (31%) and two did not provide this information. The mean (±s.d.) duration of clinical experience was 15.6±12.2 years (range 2-40 years). Three main themes were identified: (1) effects on workflow: although some participants reported that EMR facilitated easier access to real-time patient data, others indicated that workflow was disrupted by the EMR being slow and difficult to navigate, system outages and lack of interoperability between the EMR and other systems; (2) effects on patient care and communication: some participants reported that the EMR improved their communication with patients and reduced medication errors, whereas others reported a negative effect on patient care and communication; and (3) negative effects of the EMR on nurses' and midwives' personal well-being, including frustration, stress and exhaustion. These experiences were often reported in the context of cognitive workload due to having to use multiple systems simultaneously or extra work associated with EMR outages.ConclusionNurses' and midwives' experiences of the EMR were complex and mixed. Nurses and midwives require significant training and ongoing technical support in the first 12 months after implementation of an EMR system. Including nurses and midwives in the design and refinement of the EMR will ensure that the EMR aligns with their workflow.What is known about the topic?Studies reporting nurses' and midwives' experiences of using EMR are scarce and mostly based in countries where whole-of-service implementations are carried out, funded by governments.What does this paper add?Nurses and midwives perceive benefits of using an EMR relatively soon after implementation in terms of their workflow and patient care. However, in the first year after EMR implementation, nurses and midwives experience some negative effects on workflow, patient care and their own well-being. The effects on clinical workflow are further compounded by EMR downtime (scheduled and unscheduled) and hybrid systems that require users to access other technology systems alongside the EMR.What are the implications for practitioners?In countries like Australia, whole-of-service, simultaneous implementation of EMR systems using best-available server technology may not be possible due to funding constraints. In these circumstances, nurses and midwives may initially experience increased workload and frustration. Ongoing training and technical support should be provided to nurses and midwives for several months following implementation. Including nurses and midwives in the design of the EMR will result in better alignment with their specific workflow, thus maximising benefits of EMR implementation.
Collapse
Affiliation(s)
- Karen Wynter
- School of Nursing and Midwifery, Deakin University, Geelong, Vic. 3220, Australia
| | - Sara Holton
- School of Nursing and Midwifery, Deakin University, Geelong, Vic. 3220, Australia
| | - Lemai Nguyen
- Department of Information Systems and Business Analytics, Deakin Business School, Deakin University, Burwood, Vic. 3125, Australia
| | - Helen Sinnott
- Nursing and Midwifery Informatics, Western Health, Footscray, Vic. 3011, Australia
| | - Nilmini Wickramasinghe
- Iverson Health Innovation Research Institute, Swinburne University of Technology, Hawthorn, Vic. 3122, Australia
| | - Shane Crowe
- Nursing and Midwifery Executive, Western Health, St Albans, Vic. 3021, Australia
| | - Bodil Rasmussen
- School of Nursing and Midwifery, Deakin University, Geelong, Vic. 3220, Australia
| |
Collapse
|
16
|
Alharaibi MA, Alhifany AA, Asiri YA, Alwhaibi MM, Ali S, Jaganathan PP, Alhawassi TM. Prescribing errors among adult patients in a large tertiary care system in Saudi Arabia. Ann Saudi Med 2021; 41:147-156. [PMID: 34085548 PMCID: PMC8176371 DOI: 10.5144/0256-4947.2021.147] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Multiple studies have investigated medication errors in hospitals in Saudi Arabia; however, prevalence data on prescribing errors and associated factors remains uncertain. OBJECTIVE Assess the prevalence, type, severity, and factors associated with prescribing errors. DESIGN Retrospective database review. SETTING Large tertiary care setting in Riyadh. PATIENTS AND METHODS We described and analyzed data related to prescribing errors in adults (>14 years of age) from the Medication Error Electronic Report Forms database for the two-year period from January 2017 to December 2018. MAIN OUTCOME MEASURE The prevalence of prescribing errors and associated factors among adult patients. SAMPLE SIZE 315 166 prescriptions screened. RESULTS Of the total number of inpatient and outpatient prescriptions screened, 4934 prescribing errors were identified for a prevalence of 1.56%. The most prevalent types of prescribing errors were improper dose (n=1516; 30.7%) and frequency (n=987; 20.0%). Two-thirds of prescribing errors did not cause any harm to patients. Most prescribing errors were made by medical residents (n=2577; 52%) followed by specialists (n=1629; 33%). Prescribing errors were associated with a lack of documenting clinical information (adjusted odds ratio: 14.1; 95% CI 7.7-16.8, P<.001) and prescribing anti-infective medications (adjusted odds ratio 2.9; 95% CI 1.3-5.7, P<.01). CONCLUSION Inadequate documentation in electronic health records and prescribing of anti-infective medications were the most common factors for predicting prescribing errors. Future studies should focus on testing innovative measures to control these factors and their impact on minimizing prescribing errors. LIMITATIONS Polypharmacy was not considered; the data are from a single healthcare system. CONFLICT OF INTEREST None.
Collapse
Affiliation(s)
- Maryam Ali Alharaibi
- From the Department of Pharmaceutical Services, King Saud Medical City, Riyadh, Saudi Arabia.,From the College of Pharmacy, Riyadh Elm University, Riyadh, Saudi Arabia
| | - Abdullah A Alhifany
- From the Clinical Pharmacy Department, College of Pharmacy, Umm Al Qura University, Makkah, Saudi Arabia
| | - Yousif A Asiri
- From the Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Monira M Alwhaibi
- From the Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.,From the Medication Safety Research Chair, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Sheraz Ali
- From the School of Pharmacy and Pharmacology, University of Tasmania, Hobart, Australia
| | | | - Tariq M Alhawassi
- From the Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.,From the Medication Safety Research Chair, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| |
Collapse
|
17
|
Khader YS, Shattnawi KK, Al-Sheyab N, Alyahya M, Batieha A. The usability of Jordan stillbirths and neonatal deaths surveillance (JSANDS) system: results of focus group discussions. ACTA ACUST UNITED AC 2021; 79:29. [PMID: 33678194 PMCID: PMC7937354 DOI: 10.1186/s13690-021-00551-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 02/25/2021] [Indexed: 11/26/2022]
Abstract
Background Jordan Stillbirths and Neonatal Deaths Surveillance system (JSANDS) is a newly developed system and is currently implemented in five large hospitals in Jordan. This study aimed at exploring the healthcare professionals’ perception about the usability of JSANDS. Methods A descriptive qualitative approach, using focus group discussions, was adopted. A total of 5 focus groups including 23 focal points were conducted in five participating hospitals in Jordan. Results Data analysis identified nine main issues related to the JSANDS system: the system usefulness, the system performance, data quality, the system limitations, human rights, female empowerment, nurses’ competencies strengthened, the sustainability of the JSANDS, and COVID-19 impact on the system. Users reported that JSANDS data were useful, the system was simple and easy to use, and the data were accurate and complete. However, some users reported that some technical issues need to be enhanced. Conclusions JSANDS was perceived positively by the current users. According to them, it provides a formative and comprehensive data on stillbirths and neonatal deaths and their causes, and therefore, was recommended to be adopted by its users and scaled up. Supplementary Information The online version contains supplementary material available at 10.1186/s13690-021-00551-1.
Collapse
Affiliation(s)
- Yousef S Khader
- Epidemiology, Medical Education and Biostatistics, Department of Community Medicine, Public Health and Family Medicine/ Faculty of Medicine, Jordan University of Science & Technology, Irbid, 22110, Jordan.
| | - Khulood K Shattnawi
- Maternal & Child Health Nursing Department, Faculty of Nursing, Jordan University of Science and Technology, P.O.Box (3030), Irbid, 22110, Jordan
| | - Nihaya Al-Sheyab
- Child and Adolescent Health, Allied Medical Sciences Department, Faculty of Applied Medical Sciences, Adjunct professor at the Faculty of Nursing, Jordan University of Science and Technology, P.O.Box (3030), Irbid, 22110, Jordan
| | - Mohammad Alyahya
- Health Management and Policy, Department of Health Management and Policy, Faculty of Medicine, Jordan University of Science and Technology, P.O.Box (3030), Irbid, 22110, Jordan
| | - Anwar Batieha
- Department of Public Health, Jordan University of Science and Technology, Irbid, Jordan
| |
Collapse
|
18
|
Tsai CH, Eghdam A, Davoody N, Wright G, Flowerday S, Koch S. Effects of Electronic Health Record Implementation and Barriers to Adoption and Use: A Scoping Review and Qualitative Analysis of the Content. Life (Basel) 2020; 10:E327. [PMID: 33291615 PMCID: PMC7761950 DOI: 10.3390/life10120327] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 11/30/2020] [Accepted: 12/01/2020] [Indexed: 12/21/2022] Open
Abstract
Despite the great advances in the field of electronic health records (EHRs) over the past 25 years, implementation and adoption challenges persist, and the benefits realized remain below expectations. This scoping review aimed to present current knowledge about the effects of EHR implementation and the barriers to EHR adoption and use. A literature search was conducted in PubMed, Web of Science, IEEE Xplore Digital Library and ACM Digital Library for studies published between January 2005 and May 2020. In total, 7641 studies were identified of which 142 met the criteria and attained the consensus of all researchers on inclusion. Most studies (n = 91) were published between 2017 and 2019 and 81 studies had the United States as the country of origin. Both positive and negative effects of EHR implementation were identified, relating to clinical work, data and information, patient care and economic impact. Resource constraints, poor/insufficient training and technical/educational support for users, as well as poor literacy and skills in technology were the identified barriers to adoption and use that occurred frequently. Although this review did not conduct a quality analysis of the included papers, the lack of uniformity in the use of EHR definitions and detailed contextual information concerning the study settings could be observed.
Collapse
Affiliation(s)
- Chen Hsi Tsai
- Health Informatics Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, 171 77 Stockholm, Sweden; (C.H.T.); (A.E.); (N.D.)
| | - Aboozar Eghdam
- Health Informatics Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, 171 77 Stockholm, Sweden; (C.H.T.); (A.E.); (N.D.)
| | - Nadia Davoody
- Health Informatics Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, 171 77 Stockholm, Sweden; (C.H.T.); (A.E.); (N.D.)
| | - Graham Wright
- Department of Information Systems, Rhodes University, Grahamstown 6140, South Africa; (G.W.); (S.F.)
| | - Stephen Flowerday
- Department of Information Systems, Rhodes University, Grahamstown 6140, South Africa; (G.W.); (S.F.)
| | - Sabine Koch
- Health Informatics Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, 171 77 Stockholm, Sweden; (C.H.T.); (A.E.); (N.D.)
| |
Collapse
|
19
|
Seu M, Cho BH, Pigott R, Sarmiento S, Pedreira R, Bhat D, Sacks J. Trends and Perceptions of Electronic Health Record Usage among Plastic Surgeons. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 8:e2709. [PMID: 32440400 PMCID: PMC7209869 DOI: 10.1097/gox.0000000000002709] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 01/27/2020] [Indexed: 11/25/2022]
Abstract
Background Electronic health records (EHRs) should help physicians stay organized, improve patient safety, and facilitate communication with both patients and fellow healthcare providers. However, few studies have directly evaluated physician satisfaction with EHR and its perceived impact on patient care. This study assessed trends and perceptions of EHR within the American plastic surgery community. Methods An Institutional Review Board-approved survey that assessed demographics, patterns of EHR use, and attitudes toward EHR was deployed by the American Society of Plastic Surgeons Member Survey Research Services. Statistical analyses were performed using Stata 14.2 and QDA Miner Lite software (Version 2.0; Provalis, Montreal, Canada). Significance level was P < 0.05. Results Among plastic surgeons who use EHR, EPIC Systems software (Epic, Verona, Wisc.) was the most common vendor, with users noting a net positive effect on the quality of care they provided to patients. Younger age and less years of experience were correlated with a more positive attitude toward EHR. Positive attitude was closely linked to shared responsibility among support staff over data entry, whereas negative attitude was tightly tied to the perceived time wasted because of EHR, followed by poor technical support and design. Conclusions EHR use among plastic surgeons was more common in academic-associated specialties and larger practice groups. Overall, age and practice type had weak associations with perceptions of EHR usage. On average, there were slightly more positive perceptions of EHR usage than negative. The most commonly perceived issues with EHR were wasted time and barriers to user-friendliness. These findings suggest the need for greater physician involvement in EHR optimization.
Collapse
Affiliation(s)
- Michelle Seu
- Loyola University Chicago Stritch School of Medicine, Maywood, Ill
| | - Brian H Cho
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Md
| | - Rachel Pigott
- Bel Air Center for Plastic and Hand Surgery, Bel Air, Md
| | - Samuel Sarmiento
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Md
| | | | - Deepa Bhat
- Department of Plastic and Reconstructive Surgery, Albany Medical Center, Albany, N.Y
| | - Justin Sacks
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine, Baltimore, Md
| |
Collapse
|
20
|
Nurse Managers' Experience in Preparing a Computerized Work Schedule: A Descriptive Qualitative Study. Comput Inform Nurs 2020; 38:111-115. [PMID: 32134748 DOI: 10.1097/cin.0000000000000621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
21
|
Tajabadi A, Ahmadi F, Sadooghi Asl A, Vaismoradi M. Unsafe nursing documentation: A qualitative content analysis. Nurs Ethics 2019; 27:1213-1224. [PMID: 31476968 DOI: 10.1177/0969733019871682] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND Nursing documentation as a pivotal part of nursing care has many implications for patient care in terms of safety and ethics. OBJECTIVES To explore factors influencing nursing documentation from nurses' perspectives in the Iranian nursing context. METHODS This qualitative study was carried out using a qualitative content analysis of data collected from 2018 to 2019 in two urban areas of Iran. Semi-structured interviews (n = 15), observations, and reviews of patients' medical files were used for data collection. ETHICAL CONSIDERATIONS This study was conducted in accordance with the ethical principles of research and regulations in terms of confidentiality of data, anonymity, and provision of informed consent. FINDINGS The main theme of this study was "unsafe documentation." Two categories, "types of errors in reporting" and "reasons of errors in reporting," and 12 subcategories were developed indicating factors influencing nursing documentation in the Iranian nursing context. CONCLUSION In general, individual, organizational, and national factors affected nursing documentation in Iran. In this respect, hiring more nurses, application of reforms in the healthcare management structure, devising appropriate regulations regarding division of labor, constant education of healthcare staff, establishment of clinical governance, improvement of interpersonal relationships, development of hardware and software techniques for documentation, and provision of support should be done to improve the quality of nursing documentation. The above-mentioned suggestions can help nurses with a safe, ethical, lawful, and reliable documentation in nursing practice.
Collapse
|
22
|
Ayanlade O, Oyebisi T, Kolawole B. Health Information Technology Acceptance Framework for diabetes management. Heliyon 2019; 5:e01735. [PMID: 31193710 PMCID: PMC6539785 DOI: 10.1016/j.heliyon.2019.e01735] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 04/09/2019] [Accepted: 05/10/2019] [Indexed: 12/25/2022] Open
Abstract
This study examined the level of acceptance of Health Information Technology (HIT) as tools for diabetes care and management, in six selected tertiary hospitals in southwestern zone of Nigeria. Using both quantitative and qualitative methods, this study was conducted amongst selected healthcare stakeholders namely Nurses, Doctors, Laboratory Scientists, Pharmacists, ICT unit Professionals, Medical Record Officers, and Type-2 diabetes out-patients available in the designated hospitals. Adapting Technology Acceptance and Chronic Care Models, the level of HIT acceptance by the respondents in the study area was measured in terms of Perceived Ease-of-Use, Perceived Usefulness, and the Perceived Unintended Consequences relating to HIT, while also considering the roles of the government, community and healthcare organizations. One hundred and fifty (150) respondents were examined, each for both Staff and Patients, and the factor variables studied on a 5-point Likert rating scale of measurement from 1 (Strongly Disagree) to 5 (Strongly Agree). The results revealed strong perception of Staff and Patients about HIT implementation and acceptance and showed that in some cases, the perception of Staff and patients about HIT acceptance are the same, while different in some. The study concluded that for acceptability of HIT, hospitals have to embark on 'continuous' training for the HIT users, so that users would familiarize themselves with the system, and it will be fully incorporated into their workflow. Based on the findings, a conceptual Health Information Technology Acceptance Framework for Chronic diseases' management, especially for diabetes mellitus was developed.
Collapse
Affiliation(s)
- O.S. Ayanlade
- African Institute for Science Policy and Innovation (AISPI), Obafemi Awolowo University, Ile-Ife, Nigeria
| | - T.O. Oyebisi
- African Institute for Science Policy and Innovation (AISPI), Obafemi Awolowo University, Ile-Ife, Nigeria
| | - B.A. Kolawole
- Department of Medicine, Faculty of Clinical Sciences, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria
| |
Collapse
|
23
|
Patel MR, Friese CR, Mendelsohn-Victor K, Fauer AJ, Ghosh B, Bedard L, Griggs JJ, Manojlovich M. Clinician Perspectives on Electronic Health Records, Communication, and Patient Safety Across Diverse Medical Oncology Practices. J Oncol Pract 2019; 15:e529-e536. [PMID: 31009284 DOI: 10.1200/jop.18.00507] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE We know little about how increased technological sophistication of clinical practices affects safety of chemotherapy delivery in the outpatient setting. This study investigated to what degree electronic health records (EHRs), satisfaction with technology, and quality of clinician-to-clinician communication enable a safety culture. METHODS We measured actions consistent with a safety culture, satisfaction with practice technology, and quality of clinician communication using validated instruments among 297 oncology nurses and prescribers in a statewide collaborative. We constructed an index to reflect practice reliance on EHRs (1 = "all paper" to 5 = "all electronic"). Linear regression models (with robust SEs to account for clustering) examined relationships between independent variables of interest and safety. Models were adjusted for clinician age. RESULTS The survey response rate was 68% (76% for nurses and 59% for prescribers). The mean (standard deviation) safety score was 5.3 (1.1), with a practice-level range of 4.9 to 5.4. Prescribers reported fewer safety actions than nurses. Higher satisfaction with technology and higher-quality clinician communication were significantly associated with increased safety actions, whereas increased reliance on EHRs was significantly associated with lower safety actions. CONCLUSION Practices vary in their performance of patient safety actions. Supporting clinicians to integrate technology and strengthen communication are promising intervention targets. The inverse relationship between reliance on EHRs and safety suggests that technology may not facilitate clinicians' ability to attend to patient safety. Efforts to improve cancer care quality should focus on more seamless integration of EHRs into routine care delivery and emphasize increasing the capacity of all care clinicians to communicate effectively and coordinate efforts when administering high-risk treatments in ambulatory settings.
Collapse
Affiliation(s)
- Minal R Patel
- 1 University of Michigan School of Public Health, Ann Arbor, MI.,2 University of Michigan Rogel Cancer Center, Ann Arbor, MI
| | - Christopher R Friese
- 1 University of Michigan School of Public Health, Ann Arbor, MI.,2 University of Michigan Rogel Cancer Center, Ann Arbor, MI.,3 University of Michigan School of Nursing, Ann Arbor, MI
| | | | - Alex J Fauer
- 3 University of Michigan School of Nursing, Ann Arbor, MI
| | - Bidisha Ghosh
- 3 University of Michigan School of Nursing, Ann Arbor, MI
| | - Louise Bedard
- 4 Michigan Oncology Quality Consortium, Ann Arbor, MI
| | - Jennifer J Griggs
- 1 University of Michigan School of Public Health, Ann Arbor, MI.,2 University of Michigan Rogel Cancer Center, Ann Arbor, MI.,4 Michigan Oncology Quality Consortium, Ann Arbor, MI.,5 University of Michigan, Ann Arbor, MI
| | | |
Collapse
|
24
|
Alsharo M, Alnsour Y, Alabdallah M. How habit affects continuous use: evidence from Jordan's national health information system. Inform Health Soc Care 2018; 45:43-56. [PMID: 30457025 DOI: 10.1080/17538157.2018.1540423] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Implementing a health information system (HIS) to enhance healthcare services and patients' experience has become a growing trend in developing countries. Yet little is known about acquainted users' attitudes on continuing the use of an HIS after adoption. Healthcare professionals (physicians and nurses in particular) are reluctant to use HISs because they perceive them as an interruption of their interaction with patients, thus negatively influencing their efficiency. In this study, we extend the technology acceptance model (TAM) by integrating habit as an exogenous variable that affects HISs' perceived ease of use (PEOU) and perceived usefulness (PU) to investigate experienced healthcare professionals' attitudes in continuing to use an HIS. The setting of this study is a developing country (Jordan) that implemented a nationwide HIS named Hakeem. The findings show that in the context of healthcare, attitude is the major determinant to continue using HISs. Findings also show that habit significantly increases healthcare professionals' perception of PU and PEOU, which improves their attitudes toward continuing to use HISs. These findings have implications for both research and practice.
Collapse
Affiliation(s)
- Mohammad Alsharo
- Department of Information Systems, Al Albayt University, Al-Mafraq, Jordan
| | - Yazan Alnsour
- Department of Management Information Systems, University of Illinois at Springfield, Springfield, USA
| | - Mohammad Alabdallah
- Department of Information Systems, University of San Francisco, San Francisco, USA
| |
Collapse
|