The implementation of electronic records related to the nursing process: integrative review / A implementação dos registros eletrônicos relacionados ao processo de enfermagem: revisão integrativa

Objetivo O estudo objetivou identificar quais estratégias estão sendo utilizadas na implementação de registros eletrônicos relacionados ao processo de enfermagem, nas bases de dados: PubMed, Scopus e Web of Science. Métodos Trata-se de uma revisão integrativa na qual os descritores utilizados foram electronic healthrecords e nursing process. Resultados Os dados encontrados indicam que os estudos em sua maioria foram pesquisas quantitativas, publicadas no periódico Nursing informatics (Studies in Health Technology and Informatics) desenvolvidas em universidades e no continente americano. Conclusões Os dados apontam que a maior parte das pesquisas são referentes a usabilidade do registro eletrônico em saúde. Outros aspectos abordados foram as fragilidades e perspectivas associados ao uso do registro eletrônico, bem como o processo de enfermagem em sistemas informatizados

Kemampuan Informatika Perawat Sebagai Modal Penerapan Pencatatan Keperawatan Elektronik di Rumah Sakit

The implementation of Information Technology in nursing improves the quality of care. Electronic nursing record is an innovation that enhances the efficiency of nursing care. The informatics skill is needed for nurses to adapt with the innovation of Information Technology. This paper aims to discuss the informatics skill of nurses at one public hospital in Pekanbaru, Riau, Indonesia. This study was analytical study with cross sectional approach. This study involved 237 nurses and used purposive sampling technique. The data was being taken by using self- assessed nursing informatics skill/ NICAT questionnaire which divides the informatics skill in to beginner, advance beginner, competent, proficient and expert. The result of the study showed that the majority of nurses’ informatics skill was competent (49.4%) and only 4.6% that is expert. Informatics skill of the nurses related to the sex, education level and length of work. The informatics training will help nurses to improve their informatics skill

Registered Nurses\u27 Intention To Use Electronic Documentation Systems: A Mixed Methods Study

BACKGROUND: Home care in Ontario has become the fastest growing sector and cornerstone of the healthcare system. As a result of the increased shift to the home care sector in Ontario, there have been several health information technology (HIT) initiatives to improve the quality and delivery of health care services to patients. This is exemplified with the province-wide development and implementation of electronic documentation systems (EDS). Electronic documentation systems have the potential to ensure timely, up-to-date and comprehensive patient health and care-related information is available and accessible to healthcare providers such as registered nurses regardless of their physical location. Access to patient health and care-related information supports high-quality nursing care, decision-making, and care delivery processes. Despite the benefits of EDS (i.e., improved workflow, reduced diagnostic and laboratory tests and adverse drug events), low intention by registered nurses to use these systems is well documented. Existing evidence suggests that an expressed intention to use HIT such as EDS is a direct predictor and antecedent of behavioural usage. Despite the growing efforts to understand registered nurses’ perceptions and overall intention to use EDS in practice, there is limited knowledge about registered nurses’ intention to use EDS in the context of home care practice. AIMS: The purpose of this study was to understand and examine factors that influence nurses’ intention and overall perception of using EDS in their home care practice. The conceptual model framing this study was adapted from the Unified Theory of Acceptance and Use of Technology (UTAUT) to delineate the relationships among factors that influence registered nurses’ intention to use EDS in home care practice. METHOD: A sequential, explanatory mixed methods design, using a sample of nurses from Ontario who are currently practicing within the home care sector were recruited to address the study’s objectives. Data were collected using both quantitative (online survey) and qualitative (semi-structured individual telephone interviews) methods. Quantitative data were analyzed with descriptive statistics and hierarchical multiple regression analysis and qualitative data were analyzed with content and inductive thematic analysis. RESULTS: Individual, technological and organizational / environmental characteristics were found to influence nurses’ intention, level of comfort and experience with EDS usage in home care practice. Additional factors found to influence home care nurses’ experience with EDS usage included: the development and employment of workarounds, the influence of nurse-patient interaction amidst system usage, and the ability to provide input towards the system design. CONCLUSION: Nurses play a significant role in the delivery of home health care services to Ontarians. The findings highlight the importance for: a) further exploration of the most appropriate model and / or adaptation of a model identifying a range of factors influencing nurses’ intention to use EDS in different healthcare contexts; b) continued integration of nursing informatics competencies within nursing curricula; c) an organizational culture that supports the use of EDS in nurses’ home practice (i.e., enlisting user champions and providing adequate training and IT support); and d) having representation of nurses in the EDS design and / or implementation processes through a user-centered design approach

Two years of unintended consequences: introducing an electronic health record system in a hospice in Scotland

Aims and objectivesThe aim of the study was to explore the impact of implementing an electronic health record system on staff at a Scottish hospice.BackgroundElectronic health records are broadly considered preferable to paper based systems. However, changing from one system to the other is difficult. This study analysed the impact of this change in a Scottish hospice.DesignNaturalistic prospective repeated measures mixed methods approach.MethodData on the usability of the system, staff engagement and staff experience were obtained at four time points spanning 30 months from inception. Quantitative data were obtained from surveys, qualitative from Concurrent Analysis of free text comments and focus group. Participants were all 150 employees of a single hospice in Scotland.ResultsBoth system usability and staff engagement scores decreased for the first two years before recovering at 30 months. Staff experience data pointed to two main challenges:1.Technical issues, with subthemes of accessibility and usability.2.Cultural issues, with sub themes of time, teamwork, care provision and perception of change.ConclusionIt took 30 months for system usability and staff engagement scores to rise, after falling significantly for the first two years. The unintended outcomes of implementation included challenges to the way the patient story was both recorded and communicated. Nevertheless this process of change was found to be consistent with the ‘J curve’ theory of organizational change, and as such is both predictable and manageable for other organizations.Relevance to practiceIt is known that implementing an electronic health record system is complex. This paper puts parameters on this complexity by defining both the nature of the complexity (‘J’ curve) and the time taken for the organisation to begin recovery from the challenges (two years). Understanding these parameters will help health organisations across the world plan more strategically

Evaluasi Usability Terhadap Antarmuka Pengguna Sistem Informasi Kesehatan Menggunakan Heuristic Walkthrough: Studi Kasus pada Sistem Informasi Kesehatan Primer Poliklinik Pabrik Gula Kebonagung Malang Indonesia

SIKP-KA adalah sistem rekam medis elektronik berbasis web yang berisi modul yang dapat digunakan oleh profesional kesehatan Poliklinik Pabrik Gula Kebonagung. Sistem rekam medis elektronik digunakan karena manfaatnya yang antara lain adalah: resep yang lebih andal, akses yang lebih cepat ke catatan pasien, dan pengurangan biaya karena jumlah dokumen kertas yang menurun. Agar manfaat ini dapat dicapai, usability dari suatu sistem rekam medis elektronis harus memungkinkan pengguna mencapai hasil yang diharapkan. Untuk mengetahui permasalahan usability dari SIKP-KA, evaluasi usability perlu dilakukan. Dengan menggunakan metode heuristic walkthrough yang terdiri dari cognitive walkthrough dan heuristic evaluation, maka dapat diketahui permasalahan usability apa saja yang terdapat pada SIKP-KA. Dalam penelitian ini, evaluasi menggunakan cognitive walkthrough dilakukan oleh subject matter expert yang terdiri dari staf administrasi poliklinik, perawat, dokter serta tenaga kefarmasian dan 3 usability expert. Evaluasi cognitive walkthrough menghasilkan pada tahap mana saja permasalahan usability ditemukan pada SIKP-KA. Sedangkan evaluasi menggunakan heuristic evaluation dilakukan oleh usability expert dan menemukan masalah usability dengan membandingkan SIKP-KA terhadap heuristic yang ditentukan serta memberikan severity rating pada setiap masalah yang ditemukan. Setelah evaluasi dilakukan, cognitive walkthrough menemukan 44 masalah yang mana 54% dari seluruh masalah cognitive walkthrough juga ditemukan pada heuristic evaluation. Sedangkan heuristic evaluation menemukan 20 masalah yang mana heuristic dengan jumlah masalah terbanyak adalah H-3 (User control and freedom) dengan 35% dari seluruh masalah heuristic evaluation. Berdasarkan hasil evaluasi, peneliti memberikan 33 rekomendasi perbaikan terhadap usability SIKP-KA. Rekomendasi perbaikan ini terdiri dari 3 jenis saran perbaikan yaitu, perbaikan desain antarmuka pengguna, perbaikan sistem, dan pelatihan pengguna

Relationship Between Information System Success Model Dimensions and Electronic Health Records Use

The rise in the use of electronic health records (EHRs) in health care facilities necessitates a standardized tool for evaluating their effectiveness. Delone and McLean’s information system success model (ISSM) was the theoretical foundation, which consists of seven dimensions namely system, information, service qualities, user satisfaction, use, system usefulness, and net benefits. The purpose of this study was to examine EHRs’ efficiency and identify ISSM dimensions that influenced net benefits, the dependent variable. The research questions examined the relationship between dimensions of ISSM and the dimensions that affect net benefits. Participants were recruited using purposeful sampling via social media and email and accessed the survey through a link provided. Two hundred and one registered nurses who worked at least 20 hours per week in acute and primary care settings completed the survey consisting of 60 items. Data were analyzed with SPSS version 27 for Pearson correlation and multiple linear regression. Results indicated a significant positive relationship between dimensions (r = .036 - .816, p \u3c .05). From the regression analysis, information quality [B = .223, 95% CI (.070, .376), p \u3c .05], user satisfaction [B = .281, 95% CI (.138, .424), p \u3c .05], and system usefulness [B = .433, 95% CI (.348, .518), p \u3c .05] were positive predictors of net benefits. Service and system qualities and use did not predict net benefits. This study promotes positive social change by validating the survey tool for U.S. health care. Recommendations for future studies include exploring how nursing practice setting influence nurse users’ view of EHRs’ efficiency

Guidelines for the user interface design of electronic medical records in optometry

With the prevalence of digitalisation in the medical industry, e-health systems have largely replaced the traditional paper-based recording methods. At the centre of these e-health systems are Electronic Health Records (EHRs) and Electronic Medical Records (EMRs), whose benefits significantly improve physician workflows. However, provision for user interface designs (UIDs) of these systems have been so poor that they have severely hindered physician usability, disrupted their workflows and risked patient safety. UID and usability guidelines have been provided, but have been very high level and general, mostly suitable for EHRs (which are used in general practices and hospitals). These guidelines have thus been ineffective in applicability for EMRs, which are typically used in niche medical environments. Within the niche field of Optometry, physicians experience disrupted workflows as a result of poor EMR UID and usability, of which EMR guidelines to improve these challenges are scarce. Hence, the need for this research arose, aiming to create UID guidelines for EMRs in Optometry, which will help improve the usability of the optometrists’ EMR. The main research question was successfully answered to produce the set of UID Guidelines for EMRs in Optometry, which includes guidelines built upon from literature and made contextually relevant, as well as some new additions, which are more patient focused. Design Science Research (DSR) was chosen as a suitable approach, and the phased Design Science Research Process Model (DSRPM) was used to guide this research. A literature review was conducted, including EHR and EMR, usability, UIDs, Optometry, related fields, and studies previously conducted to provide guidelines, frameworks and models. The review also included studying usability problems reported on the systems and the methods to overcome them. Task Analysis (TA) was used to observe and understand the optometrists’ workflows and their interactions with their EMRs during patient appointments, also identifying EMR problem areas. To address these problems, Focus Groups (FGs) were used to brainstorm solutions in the form of EMR UID features that optometrists’ required to improve their usability. From the literature review, TAs and FGs, proposed guidelines were created. The created guidelines informed the UID of an EMR prototype, which was successfully demonstrated to optometrists during Usability Testing sessions for the evaluation. Surveys were also used for the evaluation. The results proved the guidelines were successful, and were usable, effective, efficient and of good quality. A revised, final set of guidelines was then presented. Future researchers and designers may benefit from the contributions made from this research, which are both theoretical and practical