Providers' assessment of a novel interactive health information technology in a pediatric intensive care unit

Objective: To explore perceptions of critical care providers about a novel collaborative inpatient health information technology (HIT) in a pediatric intensive care unit (PICU) setting. Methods: This cross-sectional, concurrent mixed methods study was conducted in the PICU of a large midwestern children's hospital. The technology, the Large Customizable Interactive Monitor (LCIM), is a flat panel touch screen monitor that displays validated patient information from the electronic health record. It does not require a password to login and is available in each patient's room for viewing and interactive use by physicians, nurses, and families. Quantitative data were collected via self-administered, standardized surveys, and qualitative data via in-person, semistructured interviews between January and April 2015. Data were analyzed using descriptive statistics and inductive thematic analysis. Results: The qualitative analysis showed positive impacts of the LCIM on providers' workflow, team interactions, and interactions with families. Providers reported concerns regarding perceived patient information overload and associated anxiety and burden for families. Sixty percent of providers thought that LCIM was useful for their jobs at different levels, and almost 70% of providers reported that LCIM improved information sharing and communication with families. The average overall satisfaction score was 3.4 on a 0 to 6 scale, between "a moderate amount" and "pretty much." Discussion and Conclusion: This study provides new insight into collaborative HIT in the inpatient pediatric setting and demonstrates that using such technology has the potential to improve providers' experiences with families and just-in-time access to EHR information in a format more easily shared with families

Towards understanding healthcare professionals’ adoption and use of technologies in clinical practice: using Qmethodology and models of technology acceptance

Background: Globally, technologies have been recognised to improve productivity across different areas of practice including healthcare. This has been achieved by the expansion of computers and other forms of information technologies (IT). Despite this advancement, there have also been growing challenges to the adoption and use of these technologies within practice sometimes with unintended or unexpected consequences. However, the barriers and drivers to IT, and more specifically e-health adoption within healthcare are little understood, especially in areas such as Sub-Saharan Africa (SSA) where e-health adoption is relatively new. Methodology: This paper describes a pilot study to develop and validate sample statements for use within a later substantive Q-methodology study. The aim of the main study was to understand factors that influence healthcare professionals’ (HCPs) attitudes towards IT adoption and use in SSA. We report on the use of this methodology to explore the subjectivity of HCPs together with the models of technology acceptance (Technology-Acceptance-Model: TAM and the Unified-Theory-of-Acceptance-and-Use-of-Technology: UTUAT) used in combination for the first time. Results: Following various stages and mapping of the two models of technology acceptance used, forty-six statements were developed at the end of the pilot study. These statements were grouped into six themes to capture the constructs of the two models used in the study. Conclusion: Findings suggest it is possible to use TAM and UTAUT to develop a comprehensive set of statements. These statements reflect choices that HCPs consider on IT/e-health adoption and use in SSA which can be used in a Q study. Keywords: E-health, Q-methodology, Healthcare professionals, Technology Acceptance Model, Unified Theory of Acceptance and Use of Technology, Sub-Saharan Africa

Towards understanding healthcare professionals’ adoption and use of technologies in clinical practice: using Qmethodology and models of technology acceptance

Background: Globally, technologies have been recognised to improve productivity across different areas of practice including healthcare. This has been achieved by the expansion of computers and other forms of information technologies (IT). Despite this advancement, there have also been growing challenges to the adoption and use of these technologies within practice sometimes with unintended or unexpected consequences. However, the barriers and drivers to IT, and more specifically e-health adoption within healthcare are little understood, especially in areas such as Sub-Saharan Africa (SSA) where e-health adoption is relatively new. Methodology: This paper describes a pilot study to develop and validate sample statements for use within a later substantive Q-methodology study. The aim of the main study was to understand factors that influence healthcare professionals’ (HCPs) attitudes towards IT adoption and use in SSA. We report on the use of this methodology to explore the subjectivity of HCPs together with the models of technology acceptance (Technology-Acceptance-Model: TAM and the Unified-Theory-of-Acceptance-and-Use-of-Technology: UTUAT) used in combination for the first time. Results: Following various stages and mapping of the two models of technology acceptance used, forty-six statements were developed at the end of the pilot study. These statements were grouped into six themes to capture the constructs of the two models used in the study. Conclusion: Findings suggest it is possible to use TAM and UTAUT to develop a comprehensive set of statements. These statements reflect choices that HCPs consider on IT/e-health adoption and use in SSA which can be used in a Q study. Keywords: E-health, Q-methodology, Healthcare professionals, Technology Acceptance Model, Unified Theory of Acceptance and Use of Technology, Sub-Saharan Africa

Interdisciplinary systematic review: does alignment between system and design shape adoption and use of barcode medication administration technology?

BACKGROUND: In order to reduce safety risks associated with medication administrations, technologies such as barcode medication administration (BCMA) are increasingly used. Examining how human factors influence adoption and usability of this technology can potentially highlight areas for improvement in design and implementation. OBJECTIVE: To describe how human factors related determinants for BCMA have been researched and reported by healthcare and human-computer interaction disciplines. DATA SOURCES: The Cumulative Index of Nursing, and Allied Health Literature, PubMed, OVID MEDLINE and Google Scholar. STUDY ELIGIBILITY CRITERIA: Primary research published from April 2000 to April 2020, search terms developed to identity different disciplinary research perspectives that examined BCMA use, used a human factors lens and were published in English. SYNTHESIS METHODS: Computerised systematic searches were conducted in four databases. Eligible papers were systematically analysed for themes. Themes were discussed with a second reviewer and supervisors to ensure they were representative of content. RESULTS: Of 3707 papers screened, 11 were included. Studies did not fit neatly into a clinical or human-computer interaction perspective but instead uncovered a range of overlapping narratives, demonstrating consensus on the key themes despite differing research approaches. Prevalent themes were misaligned design and workflow, adaptation and workarounds, mediating factors, safety, users' perceptions and design and usability. Inadequate design frequently led to workarounds, which jeopardised safety. Reported mediating factors included clarity of user needs, pre/post implementation evaluations, analysis of existing workarounds and appropriate technology, infrastructure and staffing. LIMITATIONS: Most studies were relatively small and qualitative, making it difficult to generalise findings. CONCLUSION: Evaluating interdisciplinary perspectives including human factors approaches identified similar and complementary enablers and barriers to successful technology use. Often, mediating factors were developed to compensate for unsuitable design; a collaborative approach between system designer and end users is necessary for BCMA to achieve its true safety potential

An Evidence-Based Evaluation of Medication Barcode Scanning Acceptance in a Community Hospital

Barcode scanning during medication administration is a powerful tool to prevent errors and support patient safety. In spite of the significant patient safety benefits, there is a lack of adoption and acceptance of barcode scanning. The purpose of this project was to implement an evidence-based assessment, utilizing a survey instrument based on the technology acceptance model, to understand adoption and acceptance of barcode scanning at a community hospital. Forty-four people, 38 nurses and 8 respiratory therapists, participated in the survey. Data analyses were performed using descriptive statistics, Kruskal-Wallis, Mann-Whitney U, and Spearman\u27s rho tests. The subscales for the intention to use barcode scanning and the influence of others were rated highest by the survey participants. The subscales for the training and technical support received the lowest ratings. There were significant differences among the departments on the subscale scores, with the acute inpatient area reporting the highest subscale ratings and the surgical services/procedural area reporting the lowest subscale ratings. There were no differences in the scores for the survey subscales in regards to participants\u27 age and years of computer use at work and at home. There were several themes identified related to barcode scanning issues and concerns. Recommendations to address the survey results and the barcode scanning issues were developed

Staff Education Module for Bar Code Medication Administration

Bar Code Medication Administration (BCMA) is a technology-supported nursing tool that has become the standard of practice for medication administration. When used effectively and efficiently, this tool has the potential to reduce medication errors in acute care settings. In a pediatric unit at a major urban hospital in the northeast region of the United States, the absence of a BCMA nursing staff educational module affected the use of this safety tool leading to an increase of medication errors. The purpose of this DNP project was to develop a comprehensive educational module to promote BCMA in the pediatric unit of the hospital. Two theories were used to guide the translation of research into practice. Lewin\u27s theory of planned change was used as a conceptual model to understand human behavior related to change management. Also employed was Benner\u27s novice to expert theory to define the learning process. The research question for this project involved whether a staff education module of BCMA would optimize the medication administration process and prevent medication errors. The research design included an expert panel that used a 5-point Likert scale to evaluate the BCMA education module for clearness, effectiveness, relevance and utilization in practice. Subsequently, the effectiveness of the module was determined through a descriptive analysis. Findings that resulted from the analysis of the evidence revealed 80% percent felt the education module will increase BCMA compliance and all agreed the education module would help identify areas of needed improvement with the current process. The social change of this study will impact nurses to deliver medications safely with the use of BCMA resulting in improved patient outcomes and safe medication administration