Understanding the multidimensionality of information systems use:A study of nurses' use of a mandated electronic medical record system

This study outlines the findings of a qualitative study designed to develop an understanding of nurses’ experiences using an electronic medical record system (EMR) in a mandatory usage context. Drawing upon the Unified Theory of Acceptance and Use of Technology, a combined deductive/inductive research approach was adopted to study nurses working in an urban hospital system. This approach allowed for an in-depth study of the nature and structure of mandated information systems (IS) use in a healthcare context. We found that understanding the relationship between key technology acceptance constructs and system use required a multidimensional conceptualization of usage – something not commonly found in the IS literature. We identified three facets important to gaining a holistic understanding of nurses’ use of EMR technology: time spent using the system, timing of use, and mode of use. We empirically demonstrate that the dimensions of IS use can be mandated and internalized to varying degrees even within the same organization, and that the predictors of use can be differentially associated with the dimensions of use given the degree of the mandate

Acute appendicitis following blunt abdominal trauma. Incidence or coincidence?

Inflammation of the appendix is a common cause of acute abdominal pain. The etiology and pathophysiology of appendicitis have been well described. The initiating factor often is obstruction of the appendiceal lumen by inspissated stool, barium, food, parasites, or hyperplastic lymphoid tissue. Two patients have been identified who developed appendicitis temporally related to blunt abdominal trauma, without other clear etiology. Although absolute documentation of trauma as an etiologic factor in these cases is difficult, theoretical mechanisms for the occurrence are discussed. In the setting of right lower quadrant pain following mild to moderate blunt abdominal trauma, acute appendicitis should be considered as a possibility