ACCEPTANCE AND BARRIER OF ELECTRONIC HEALTH RECORDS IN A TERTIARY HOSPITAL IN NIGERIA

Purpose: This study assesses the performance, determine the barriers and effects of electronic health records on the staff of Obafemi Awolowo Teaching Hospital, Ile-Ife, Osun State, Nigeria. Method/Approach: This study was designed to explore the experiences of staff that practised a computerized or electronic health record in Obafemi Awolowo Teaching Hospital, Osun State, Nigeria (OAUTH). This study utilized a quantitative method. The study sample includes 10 respondents from the intensive care unit, 40 respondents from the health information department, 25 respondents from nurses and 25 respondents from the medical doctors of the hospital. The respondents were purposively selected and the instrument (questionnaire) was administered using the random sampling technique. Findings/results: This study showed that there is a high performance (80%) of EHR in the hospital. Most respondents (65%) opined that EHR is easy to use. The assessment of the respondents about the ability of EHR to reduce medical error revealed that about 75% said EHR will reduce medical error. In addition to this, about 80% of the respondents said EHR is important in the transmission of patient prescription. The barrier to the implementation of electronic health record includes an inadequate computer (50%), lack of uniform hospital standard (55%), start-up financial costs (60%) and training and productivity loss. Recommendation: The hospital management, federal and state government and non-governmental organizations should work together to remove all barrier to the implementation of electronic health records through the provision of computer systems, finance, stable electricity supply, man-power training and employment of adequate staff. Article visualizations

The Moderating Effects of Age and Computer Knowledge on Nurses’ Acceptance of Information Systems: A Canadian Study

The objective of this study was to educate on the moderating effects of age and computer knowledge on nurses’ acceptance of information systems (IS). The background theoretical framework used was the technology acceptance model (TAM), which has been widely favored by healthcare researchers. A relevant research model including TAM’s core constructs, i.e., perceived usefulness (PUSS) and ease of use (PEOU), age, and computer knowledge was used. Usable data was collected from 197 registered nurses (RNs) in Nova Scotia, Canada, in a cross-sectional survey. The partial least squares (PLS) technique of structural equation modeling was used for data analysis. The results of the hypothesized relationships show that computer knowledge has a positive moderating effect on the influences of PEOU and PUSS on nurses’ attitudes toward IS (ATTI); the demographic factor of age did not. PEOU and PUSS have direct positive influence on nurses’ ATTI, which in turn impacts their behavioral intentions to use IS (BEHI). Lastly, nurses’ self-reported IS use is positively influenced by BEHI. The study’s results drew the attention of practitioners and academics to the impacts of age and computer knowledge in the discourse of nurses’ IS acceptance in work environments

Attitudes and Beliefs of Registered Nurses About the Process of Changing to an Electronic Medical Record in a Community Hospital: A Mixed Method Investigation

The change from paper charting systems to electronic medical records (EMR) is a daunting task. Many hospitals today are undergoing this process. Kotter’s Change Model informs us that the process must be guided by sound principles and lead by an engaged, focused team of dedicated employees. The studied hospital is a small hospital in rural Ohio that initiated this change in late 2012. Their computer charting initiative launched the EPIC program for EMR use throughout the facility. Nursing staff was challenged to learn and eventually become proficient in its use. Because nurses are the largest care provider group in any hospital, their ability to learn, change and adopt new care integration and documentation methods must be supported and enhanced. Benner’s Novice to Expert Model of Skill Acquisition in nursing has direct application in this transition. The purpose of this mixed-method, longitudinal study is to examine the attitudes and beliefs of nurses undergoing the change from a paper documentation system to a computer based system through the lens of Benner’s Novice to Expert Model. Nurses must accept the change to electronic medical records but they must also increase their skill level. Important factors for successful transition to electronic charting include usefulness of the software, methods of implementation as well as length of time after making the change

Attitudes and Beliefs of Registered Nurses About the Process of Changing to an Electronic Medical Record in a Community Hospital: A Mixed Method Investigation

The change from paper charting systems to electronic medical records (EMR) is a daunting task. Many hospitals today are undergoing this process. Kotter’s Change Model informs us that the process must be guided by sound principles and lead by an engaged, focused team of dedicated employees. The studied hospital is a small hospital in rural Ohio that initiated this change in late 2012. Their computer charting initiative launched the EPIC program for EMR use throughout the facility. Nursing staff was challenged to learn and eventually become proficient in its use. Because nurses are the largest care provider group in any hospital, their ability to learn, change and adopt new care integration and documentation methods must be supported and enhanced. Benner’s Novice to Expert Model of Skill Acquisition in nursing has direct application in this transition. The purpose of this mixed-method, longitudinal study is to examine the attitudes and beliefs of nurses undergoing the change from a paper documentation system to a computer based system through the lens of Benner’s Novice to Expert Model. Nurses must accept the change to electronic medical records but they must also increase their skill level. Important factors for successful transition to electronic charting include usefulness of the software, methods of implementation as well as length of time after making the change

Exploring the role of the nurse manager in supporting point-of-care nurses’ adoption of electronic health records: protocol for a qualitative research study

Introduction: An increasing number of electronic health record (EHR) systems have been implemented in clinical practice environments where nurses work. Findings from previous studies have found that a number of intended benefits of the technology have not yet been realised to date, partially due to poor system adoption among health professionals such as nurses. Previous studies have suggested that nurse managers can support the effective adoption and use of the technology by nurses. However, no known studies have identified what role nurse managers have in supporting technology adoption, nor the specific strategies that managers can employ to support their staff. Therefore, the purpose of this research is to better understand the role of the nurse manager in point-of-care nurses’ use of EHRs, and to identify strategies that may be effective in supporting clinical adoption. Methods and analysis This study will use a qualitative descriptive design. Interviews with both nurse managers and point-of-care nursing staff will be conducted in a Canadian mental health and addiction healthcare organisation where an EHR has been implemented. A semistructured interview guide will be used, and interviews will be audio recorded. Transcripts will be analysed using a directed content analysis technique. Strategies to ensure the trustworthiness of the data analysis procedure and findings will be employed. Ethics and dissemination Ethical approval for this study has been obtained. Dissemination strategies may include a paper submission to a peer-reviewed journal, a conference submission and meetings to share findings with the study site leadership team. Findings from this research will be used to inform a future study which aims to assess levels of competencies and perform a psychometric analysis of the Nursing Informatics Competency Assessment for the Nurse Leader instrument in a Canadian context

Investigating Evaluation Frameworks for Electronic Health Record: A Literature Review

BACKGROUND: There are various electronic health records (EHRs) evaluation frameworks with multiple dimensions and numerous sets of evaluation measures, while the coverage rate of evaluation measures in a common framework varies in different studies. AIM: This study provides a literature review of the current EHR evaluation frameworks and a model for measuring the coverage rate of evaluation measures in EHR frameworks. METHODS: The current study was a comprehensive literature review and a critical appraisal study. The study was conducted in three phases. In Phase 1, a literature review of EHR evaluation frameworks was conducted. In Phase 2, a three-level hierarchical structure was developed, which includes three aspects, 12 dimensions, and 110 evaluation measures. Subsequently, evaluation measures in the identified studies were categorized based on the hierarchical structure. In Phase 3, relative frequency (RF) of evaluation measures in different dimensions and aspects for each of the identified studies were determined and categorized as follows: Appropriate, moderate, and low coverage. RESULTS: Out of a total of 8276 retrieved articles, 62 studies were considered relevant. The RF range in the second and third level of the hierarchical structure was between 8.6%–91.94% and 0.2%–61%, respectively. “Ease of use” and “system quality” were the most frequent evaluation measure and dimension. Our results indicate that identified studies cover at least one and at most nine evaluation dimensions and current evaluation frameworks focus more on the technology aspect. Almost in all identified studies, evaluation measures related to the technology aspect were covered. However, evaluation measures related to human and organization aspects were covered in 68% and 84% of the identified studies, respectively. CONCLUSION: In this study, we systematically reviewed all literature presenting any type of EHR evaluation framework and analyzed and discussed their aspects and features. We believe that the findings of this study can help researchers to review and adopt the EHR evaluation frameworks for their own particular field of usage

Nurses Knowledge, Skills, and Attitude Toward Electronic Health Records (EHR)

Information technology (IT) has been rapidly integrated into the healthcare industry, including nursing, and has the ability to reduce errors, cut cost, and enhance patient care. However, approximately 45% of the current nurse workforce lacks adequate training in computer skills, which may hinder the adoption of health-related IT in the workplace. Characteristics of Rogers\u27s diffusion of innovation (relative advantage, compatibility, complexity, trialability, and observability) guided this project. This project was conducted to address the problem of IT adoption on a local level and was designed to assess whether simulation training on a generic electronic health record (EHR) system would improve the knowledge, skill, and attitude of nurses with little or no experience with EHR. A convenience sample of nurses (n = 13) unfamiliar with EHR was obtained by posting flyers in long-term care or home health agencies. The nurses completed the P.A.T.C.H. assessment scale v. 3 (2011) before and after participating in the one-time simulation training on EHR. Scores on the P.A.T.C.H. were calculated according to the established scoring system and revealed a positive increase nurses\u27 attitude and self-efficacy toward the EHR system. Posttest scores yielded an increase ranging from 0.5 to 5 points from pretest scores, with an average pretest score of 54.23 on a scale of 0-100. The results of this project are consistent with the literature and current research and illustrate the importance of addressing the need for interactive training. This project contributes to social change in practice by enhancing the awareness of EHR in nurses who are new users of IT and promoting the adoption of technology in healthcare

Conceptual informatical desing for improving quality of healthcare in patients with decubitus

Cilj ovog rada bio je ukazati na važnost evidentiranja, praćenja i izvještavanja o dekubitusu kao pokazatelju (indikatoru) kvalitete zdravstvene njege. Polazeći od važećeg Obrasca za praćenje dekubitusa iz Pravilnika o sestrinskoj dokumentaciji izrađen je prijedlog strukture elektroničkog zapisa kojim se izbjegava gomilanje podataka te omogućava brz i jednostavan pristup podatcima. Dekubitus je veliki zdravstveno-socijalni problem. Prema podatcima iz literature prevalencija dekubitusa danas nije u padu unatoč modernim tehnologijama i dostupnim pomagalima za prevenciju. Korištenje podataka putem medicinsko-informatičke aplikacije trebao bi biti sastavni, integrirani dio strategije za poboljšanje prevencije i liječenja dekubitusa te na taj način smanjiti njegovu pojavnost, poglavito tijekom hospitalizacije pacijenta. Informatičko rješenje za praćenje dekubitusa mora biti ostvareno pomoću aplikacije koja omogućuje medicinskoj sestri brz i lak unos podataka korištenjem grafičkog korisničkog sučelja uključujući i praćenje rizika za njegov nastanak, praćenje liječenja te izradu izvještaja. Istovremeno aplikacija mora omogućavati obradu i analizu podataka praktično u realnom vremenu i to kako za pojedinog pacijenta tako i na razini organizacije i upravljanja bolničkim resursima. Posebno je naglašeno da u elektronički zapis treba uključiti digitalne slike lezija koje je današnjom tehnologijom moguće jednostavno i brzo načiniti i pohraniti u računalu te se one mogu uspoređivati. Poželjno je pri slikanju staviti i neko mjerilo radi lakše usporedbe veličine. Sustav praćenja dekubitusa mora biti dio bolničkog informacijskog sustava i potpora za donošenje odluka. Podatke treba redovito analizirati i promicati važnost dekubitusa kao pokazatelja kvalitete zdravstvene njege.The aim of this qualification paper was to show the importance of recording, monitoring and reporting of pressure ulcers as a nursing care quality indicator. Starting from the existing Form for monitoring pressure ulcers included in the Rule book of nursing documentation, a proposal of the electronic health record structure is proposed with the aim to avid the accumulation of data and provision of quick and easy data access. A pressure ulcer is a major health and social problem. According to literature data, the prevalence of pressure ulcers has not declined despite modern technologies and tools available for prevention. Using data through medical informatics applications (e-Health applications) should be an integral, integrated part of the strategy to improve the prevention and treatment of pressure ulcers, and thus reduce its incidence, especially during the hospitalization of the patient. Information technology (IT) applications for monitoring pressure ulcers should allow nurses quick and easy data input using a graphical user interface including monitoring the risk of its occurrence, monitoring of treatment and the preparation of reports. At the same time the application must enable the processing and analysis of data virtually in real time, both for the individual patient and at the top level of organization and management of a hospital. It was pointed out that the electronic record should include digital images of lesions that can be easily and quickly made and stored using today's technology and used for later comparisons, in particular it would be important to make the image together with the scale. The system for monitoring pressure ulcers should be part of the hospital information system and support for decision-making. Data should be regularly analysed and the importance of pressure ulcer as an indicator of the quality of health care should be emphasized and promoted