Nursing information: users’ experiences of a system in Taiwan one year after its implementation

The effect of medical material management system app on nursing workload and stress

Aims

To develop a clinical medical material management App for nurses, in order to reduce their workload and improve the efficacy of medical material management.

Design

The single-group pre- and post-test experimental design was adopted.

Methods

The subjects were nurses in the intensive care units of a regional hospital in Hsinchu City enrolled by purposive sampling. Single-group pre-tests and post-tests were conducted. The research period was from November 2019 to March 2020. The workload, stress, and information acceptance of 57 nurses before and after the intervention of the Medical Equipment App were collected. The research tools included a structured questionnaire, which includes open questions that cover the aspects of workload, stress, and information acceptance intention of nurses, as well as a demographic questionnaire, which collects the basic personal data, including gender, age, years of service, educational level, nursing ability level, use ability of IT products, and unit type. The results were analyzed and compared using SPSS, APP Inventor, and data mining modeling to determine the effects of the App.

Results

After employing the Shift Check App, the average workload of nurses was effectively reduced, in particular, the workload reduction of the N1 level nursing ability was greater than that of N2. In addition to satisfaction, the scores of information acceptance intention in all aspects, including behavioral intention, technology use intention, and contributing factors, all increased.

Conclusion

The use of information technology products to assist medical material management in clinical practice has a significant effect on the load reduction of nurses and improvement of satisfaction.

Clinical relevance

The App developed in this study can improve nurses’ work satisfaction, quality of care and workload reduction.

Caring for Computers: The Hidden Work of Clinical Nurses during the Introduction of Health Information Systems in a Teaching Hospital in Taiwan

Implementing health information systems for enhancing patient care and management occurs worldwide. Discovering how nurses, as important system end-users, experience technology-reliant clinical practice involved focus groups (n = 25) and in-depth individual interviews with nurses (n = 4) and informatics staff (n = 3) in a major Taiwanese medical center. This qualitative study explores the unintended effects of these systems on nurses’ role and clinical practice. First, nurses’ additional role caring for computer devices supporting patient care involves highly-demanding invisible effort, especially when tackling system malfunctions affecting patients with urgent conditions. Second, nurses are resourceful in developing solutions to protect patients during unexpected technical malfunctions. Third, troubleshooting using telephone technical support as the first resort is problematic. It is argued that computerization requires nurses to care for co-clients: patients and computers. Managing technical malfunctions is an unintended consequence for nurses, reflecting the hidden work required by new technology.

The use of information technology to enhance patient safety and nursing efficiency

BACKGROUND

Issues in patient safety and nursing efficiency have long been of concern. Advancing the role of nursing informatics is seen as the best way to address this.

OBJECTIVES

The aim of this study was to determine if the use, outcomes and satisfaction with a nursing information system (NIS) improved patient safety and the quality of nursing care in a hospital in Taiwan.

METHOD

This study adopts a quasi-experimental design. Nurses and patients were surveyed by questionnaire and data retrieval before and after the implementation of NIS in terms of blood drawing, nursing process, drug administration, bar code scanning, shift handover, and information and communication integration.

RESULTS

Physiologic values were easier to read and interpret; it took less time to complete electronic records (3.7 vs. 9.1 min); the number of errors in drug administration was reduced (0.08% vs. 0.39%); bar codes reduced the number of errors in blood drawing (0 vs. 10) and transportation of specimens (0 vs. 0.42%); satisfaction with electronic shift handover increased significantly; there was a reduction in nursing turnover (14.9% vs. 16%); patient satisfaction increased significantly (3.46 vs. 3.34).

CONCLUSIONS

Introduction of NIS improved patient safety and nursing efficiency and increased nurse and patient satisfaction. Medical organizations must continually improve the nursing information system if they are to provide patients with high quality service in a competitive environment.

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

OBJECTIVES

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Attitudes of nursing staff towards computerisation: a case of two hospitals in Nairobi, Kenya

Background

The health sector is faced with constant changes as new approaches to tackle illnesses are unveiled through research. Information, communication and technology have greatly transformed healthcare practice the world over. Nursing is continually exposed to a variety of changes. Variables including age, educational level, years worked in nursing, computer knowledge and experience have been found to influence the attitudes of nurses towards computerisation. The purpose of the study was to determine the attitudes of nurses towards the use of computers and the factors that influence these attitudes.

Methods

This cross sectional descriptive study was conducted among staff nurses working at one public hospital (Kenyatta National Hospital, (KNH) and one private hospital (Aga Khan University Hospital (AKUH). A convenience sample of 200 nurses filled the questionnaires. Data was collected using the modified Nurses’ Attitudes Towards Computerisation (NATC) questionnaire.

Results

Nurses had a favorable attitude towards computerisation. Non-users had a significantly higher attitude score compared to the users (p = 0.0274). Statistically significant associations were observed with age (p = 0.039), level of education (p = 0.025), duration of exposure to computers (p = 0.025) and attitudes towards computerisation.

Conclusion

Generally, nurses have positive attitudes towards computerisation.

This information is important for the planning and implementation of computerisation in the hospital as suggested in other studies.

A survey of student nurses' and midwives' experiences of learning to use electronic health record systems in practice

AIM

The study aimed to investigate student nurses' and midwives' experiences of learning to use electronic health records (EHR) in practice.

BACKGROUND

Good record keeping and documentation are integral to nursing and midwifery practice. As EHRs become more widespread, student nurses and midwives need opportunities to access and learn how to use them in practice.

METHOD

A survey of nursing and midwifery students was conducted using questionnaires (n = 215) and three focus groups: one with midwifery students (n = 6); one with mental health nursing students (n = 5) and one with adult nursing students (n = 6). The University research ethics committee approved the study. The questionnaire data were analysed using SPSS v19. The focus group data were analysed thematically following transcription.

RESULTS

The results presented relate to two themes: 1) Preparation for using EHRs and skills development; 2) Access to EHRs and involvement. Students had variable experiences in relation to opportunities to access and use EHRs, training on EHR systems used in practice and guidance from mentors. Some mentors had concerns about students' legitimacy to access EHRs and verification of students' EHR entries was a challenging issue in some areas.

CONCLUSION

To promote opportunities for students to develop competence in using EHRs in practice, training on EHR systems in use, and clear processes for authorised access, are needed. Following the survey, the University and practice partners collaboratively established formalised EHR training for students with clear governance procedures for access and use.

Capturing information needs of care providers to support knowledge sharing and distributed decision making

BACKGROUND

This paper reports on work carried out to elicit information needs at a trans-disciplinary, nurse-managed health care clinic that serves a medically disadvantaged urban population. The trans-disciplinary model provides a "one-stop shop" for patients who can receive a wide range of services beyond traditional primary care. However, this model of health care presents knowledge sharing challenges because little is known about how data collected from the non-traditional services can be integrated into the traditional electronic medical record (EMR) and shared with other care providers. There is also little known about how health information technology (HIT) can be used to support the workflow in such a practice.

OBJECTIVES

The objective of this case study was to identify the information needs of care providers in order to inform the design of HIT to support knowledge sharing and distributed decision making.

METHODS

A participatory design approach is presented as a successful technique to specify requirements for HIT applications that can support a trans-disciplinary model of care.

RESULTS

Using this design approach, the researchers identified the information needs of care providers working at the clinic and suggested HIT improvements to integrate non-traditional information into the EMR. These modifications allow knowledge sharing among care providers and support better health decisions.

CONCLUSIONS

We have identified information needs of care providers as they are relevant to the design of health information systems. As new technology is designed and integrated into various workflows it is clear that understanding information needs is crucial to acceptance of that technology.

The multimethod evaluation of a nursing information system in taiwan

The purpose of this study was to evaluate the impact of a nursing information system on nurses' daily practice. A multimethod evaluation was used that combined both quantitative and qualitative approaches to explore the influence of this technology from different perspectives. The data collection methods included the following: an evaluation scale of the system function, focus group interviews about the users' experiences, and work sampling observation of their work pattern. The data were collected from October to December 2006. The data analysis contained 623 valid questionnaires, 24 nurses' interview content, and 22830 observed nursing activities. Overall, the results indicated that nurses gave a positive evaluation of the technology in their work routine. However, they were concerned about the inadequacy of the hardware devices and response time, training and workflow change, and personal interactions with physicians and patients. Nurses on the night shift spent more time on documentation than on any other nursing activities during the three shifts. The users' technology adoption could be attributed to device sufficiency and function, content design, and workflow efficiency. It is recommended that organizations provide sufficient computer devices, ensure the content design for nursing documentation, and implement expectations for interdisciplinary cooperation.