35 research outputs found
Determining attitude and readiness of Medical students in Kerman University of Medical Sciences concerning acceptance of Decision Support Systems for Electronic Prescription in 2017
Introduction: Clinical Decision Support Systems (CDSS) are any computer program designed to assist health care professionals in making clinical decisions, especially at the moment of action. These information systems are flexible and interactive, helping people by making use of models and rules of a comprehensive database, or on the basis of clinical guidelines, to make applicable decisions, especially solving difficult problems with common scientific methods. Therefore, these systems support complex medical decisions, increase their effectiveness, and can lead to a reduction in the types of medical errors, such as medication errors. However, knowledge and attitude of the future physicians in the country about these systems is unclear. The purpose of this study was Determining attitude and readiness of Medical students concerning acceptance of Decision Support Systems for Electronic Prescription.
Methods: This research is descriptive-analytic. The research population included general medical students of Kerman University of Medical Sciences in 2017. Out of these students, a sample of 226 people was selected by proportional sampling. Data collection was done using a standard questionnaire. The questionnaire was first translated into Persian and then its validity was confirmed by three medical informatics specialists. Data analysis was done descriptively-analytically using SPSS 19.
Results: The findings of this study showed that 17% of students (n=36) knew about this system and how to use it, and 83% of them (n=177) were willing to learn and use this system to practice their profession in the future. More than half of them (n=121) believed that using this system would Reduce errors in prescribing. 80% of them (n=170) lacked a strategic plan to implement a decision support system for electronic prescription and a lack of standard and acceptable software, and about 60% (n=128) lack of financial incentives and lack of sufficient evidence Concerned about the usefulness of using it as a potential obstacle to the implementation of this system. There was no significant difference between the age, sex and term of the students with their familiarity with this system (P>0.05).
Conclusion: The results of this study showed that while many students lack sufficient knowledge about the clinical decision support system, they are interested in learning and using it, especially in the field of prescribing drugs. This result indicates that the system is likely to be admitted if it is implemented and educated to medical students and doctors
Evaluating factors associated with implementing of evidence-based practice in nursing
Rationale, aims and objectives Evidence-based practice (EBP) has emerged as an innovation for quality improvement in health care. Nurses have important role in implementing
EBP but they face many challenges in this context. Evaluation of factors influencing
implementation of EBP seems necessary. The aims of this study were to examine nurses’
attitude towards EBP, their self-efficacy and training needs, as well as supporting factors
and barriers for implementing EBP.
Methods A cross-sectional study was conducted on 182 nurses from four teaching hospitals in Kerman, Iran. Data were collected using a questionnaire consisting of two main
sections; a section to collect socio-demographic information of participants and a section
collecting information on five topics (staff’s attitude, self-efficacy skills of EBP, supporting
factors, barriers and training needs for implementing EBP).
Results The majority (87.4%) of the nurses had not attended any formal training on EBP
and 60% of them were not familiar with the concept of EBP. Nurses’ attitude towards EBP
was unfavourable (2.57 ± 0.99) and their self-efficacy skills of EBP were poor
(2.93 ± 1.06). The most important supporting factor was mentoring by nurses who have
adequate EBP experience (3.65 ± 1.17) and the biggest barrier was difficulty judging the
quality of research papers and reports (2.46 ± 0.95). There was a moderate demand for
training in all areas of EBP (3.62 ± 1.12).
Conclusions Nursing care needs to move towards quality improvement using EBP. It is
necessary to equip nurses with knowledge and skills required for EBP. Managers should
design an appropriate strategic plan by considering supporting factors and barriers for
integrating EBP into clinical settin
Evaluating Nurses' Satisfaction With Two Nursing Information Systems
Evaluating user satisfaction is one of the methods to ensure
the usability of information systems. Considering the importance
of nursing information systems in patient health, the objective
of this study is to evaluate nurses' satisfaction with two
widely used nursing information systems (Peyvand Dadeh and
Tirazhe) in Iran. This descriptive-analytical study was done
on 230 nurses in all teaching hospitals of Kerman University
of Medical Sciences in 2015. Data were collected
using an augmented version of a questionnaire developed
by IBM. Data were analyzed by SPSS.16 using descriptive
and analytical statistical methods including t test, analysis
of variance, and Pearson correlation coefficient. The mean
of overall satisfaction with the two systems was 61 ± 2.2
and 74 ± 2.4, respectively. The mean of satisfaction with
different systems dimensions, that is, ease of use, information
quality, and interface quality, was, respectively,
24 ± 1.9, 26 ± 9.7, and 12 ± 4.7 for Tirazhe and
29 ± 1.1, 39 ± 1.04 and 13 ± 5.3 for Peyvand Dadeh system.
Nurses’ satisfaction with both systems was at a medium
level. The majority of nurses were relatively satisfied
with the information quality and user interface quality of
these systems. The results suggest that designing nursing
information systems in accordance with their users’ need
improves usability. Hence, policy and decision makers of
healthcare institutions should invest on usability when purchasing
such systems.
KEY WORDS: Computer System Usability Questionnaire,
Nursing information system, Satisfaction, Usability
evaluatio
Evaluation methods used on health information systems (HISs) in Iran and the effects of HISs on Iranian healthcare: a systematic review.
Objectives: The most important goal of a health information system (HIS) is improvement
of quality, effectiveness and efficiency of health services. To achieve this goal, health care
systems should be evaluated continuously. The aim of this paper was to study the impacts
of HISs in Iran and the methods used for their evaluation.
Methods: We systematically searched all English and Persian papers evaluating health information systems in Iran that were indexed in SID, Magiran, Iran medex, PubMed and Embase
databases until June 2013. A data collection form was designed to extract required data such
as types of systems evaluated, evaluation methods and tools.
Results: In this study, 53 out of 1103 retrieved articles were selected as relevant and reviewed
by the authors. This study indicated that 28 studies used questionnaires to evaluate the system and in 27 studies the study instruments were distributed within a research population.
In 26 papers the researchers collected the information by means of interviews, observations, heuristic evaluation and the review of documents and records. The main effects of
the evaluated systems in health care settings were improving quality of services, reducing
time, increasing accessibility to information, reducing costs and decreasing medical errors.
Conclusion: Evaluation of health information systems is central to their development and
enhancement, and to understanding their effect on health and health services. Despite
numerous evaluation methods available, the reviewed studies used a limited number of
methods to evaluate HIS. Additionally, the studies mainly discussed the positive effects of
HIS on health care services
CPOE System Design Aspects and Their Qualitative Effect on Usability
Although many studies have discussed the benefits of Computerized
Provider Order Entry (CPOE) systems, their configuration can have a great impact
on clinicians’ adoption of these systems. Poorly designed CPOE systems can lead
to usability problems, users’ dissatisfaction and may disrupt normal flow of
clinical activities. This paper reports on a literature review focused on the
identification of CPOE medication systems’ design aspects that impact CPOE
systems’ usability and create opportunities for medication errors. Our review is
based on a systematic literature search in PubMed, EMBASE and Ovid MEDLINE
for relevant publications from 1986-2006. We categorized the design aspects
extracted from relevant publications into six different groups: 1) timing of alerts,
2) log in/out procedures, 3) pick lists and drop down menus, 4) clues and
guidelines, 5) documentation and data entry options, and 6) screen display and
layout. Our review shows that the manner in which a CPOE system is configured
can have a high impact on ease of system use, task behavior of clinicians in
ordering drugs, and medication errors. Characterization of consequences
associated with certain CPOE design aspects provides insight into how CPOE
system designs can be improved to enhance physicians’ adoption of these systems
and their success. Recommendations are provided to enable CPOE system
designers to create CPOE systems that are not only more user friendly and
efficient but safer
Usability Evaluation of a Computerized Physician Order Entry for Medication Ordering
Despite CPOE (Computerized Physician Order Entry) systems’
potential to enhance patient safety by reducing medication errors, recent studies
have cast some doubts on their role in error reduction. CPOE systems with poorly
designed interfaces have proven to cause users dissatisfaction and to introduce new
kind of errors in the ordering process, suggesting a threat instead of an
enhancement of patient safety. The main objective of this study is to identify
usability problems related to a CPOE medication system’s design and determining
their severities. Two experts completed a cognitive walkthrough (CW) of an
ordering task based on a clinical scenario for ordering the consolidation phase of
chemotherapy for a leukemic patient. Fifty five usability problems were found and
classified into eleven categories. CW identified cosmetic to catastrophic problems
leading to inefficient use of the CPOE system and potentially resulting in users’
confusion, longer ordering duration, and medication errors. The complexity of the
CPOE design, its rigidness and lack of user guidance suggests the necessity to
redesign the current user interface in order to match clinicians’ ordering behaviors
and to fully support them in the medication ordering process
Electronic Prescribing Usability: Reduction of Mental Workload and Prescribing Errors Among Community Physicians
Background: Medical errors are common in hospitals, and research is always needed to find ways of reducing these. This study attempts to address three gaps in this field. First, the factors leading to the reduction of mental workload and its relationship with the reduction of prescribing errors by improving electronic prescribing (e-prescribing) usability have not been empirically examined before. Second, the past research in the field of e-prescribing usability lacks robust theoretical models. Third, there are no existing studies to examine the direct influences of user interface consistency and error prevention with the reduction of mental workload and prescribing errors. Materials and Methods: A quantitative survey method was used to collect data from 188 community physicians. The partial least squares path modeling technique was applied to analyze the data. Results: Prescribing errors were reduced by improving the information quality, user interface consistency, system ease of use, and mental workload reduction. Mental workload is reduced by ease of use, error prevention, and consistency. No significant relationships between prescribing error reduction with error prevention and also between information quality with mental workload reduction were found. Conclusions: The designers of e-prescribing should improve the error prevention and consistency of the system and make it easy to use if they wish for the system to reduce users’ mental workload. They should also improve the system information quality, ease of use, and consistency if they claim that their system reduces physicians’ prescribing errors. The system should also reduce users’ mental workload to meet this objective
Usabiility evaluation of healthcare information systems. Comparison of methods and classification of usability problems
In ziekenhuizen wordt steeds meer gebruik gemaakt van informatiesystemen, maar de usability laat vaak te wensen over. Reza Khajouei testte twee methodes om de usability te beoordelen. Hij constateert dat beide methoden ongeveer evenveel, maar verschillende problemen aan het licht brengen. Uit een enquĂŞte onder artsen en verpleegkundigen blijkt dat er veel problemen zijn met het gebruik van de informatiesystemen, maar dat men uiteindelijk toch positief is
Online Focus Groups for the Development of a Usability Evaluation Tool: Lessons Learned
Introduction: Focus group discussions are a well-established method for acquiring insights from experts in different fields. This method requires special amendments when it is used for the development of different tools in the healthcare domain. The objective of this paper is to present the lessons learned from online focus group sessions held for the development of a heuristic usability evaluation tool for mobile health applications.
Material and Methods: Two online focus group sessions were conducted with the participation of ten medical informatics experts to develop the tool. The sessions were recorded using screen recording software. The comments provided by the experts were categorized, and the lessons learned from these sessions were identified and reported.
Results: The experiences achieved from the online focus group sessions were categorized into the following ten lessons. 1. Engage the participants fully in online session discussions 2. Use an appropriate and interesting format. 3. Select an appropriate number of people for online sessions 4. Invite people having the closest expertise related to the research topic 5. Employ a technical support technician in addition to the coordinator. 6. Prevent the emergence of a new topic in sessions. 7. Arrange the required hardware and software facilities before the session. 8. Prepare the content in an appropriate language. 9. Use online tools to schedule sessions. Â 10. Use screen-recording software.
Conclusion: This paper reports the lessons learned from holding online focus group sessions in the process of developing a heuristic usability evaluation tool for mobile health applications. Although these lessons were learned in a study focusing on the development of a usability tool, they can also be used to improve the results of focus group sessions in other fields of medical informatics