eHealth;
health services research;
hospitals;
information management;
performance and evaluation;
EXPLORING NURSES REACTIONS;
INFORMATION-SYSTEMS;
SUPPORT TOOL;
CARE;
DOCUMENTATION;
TECHNOLOGY;
EXPERIENCES;
D O I:
10.1071/AH18231
中图分类号:
R19 [保健组织与事业(卫生事业管理)];
学科分类号:
摘要:
The aim of this study was to investigate the implementation of a novel electronic bedside nursing chart in an acute hospital setting. The case study used multiple data sources captured within a real-life clinical ward context. Quantitative findings included significant reductions in nurse-reported missed care (P < 0.05) and increased mean time spent at the bedside (from 21 to 28 min h(-1); P < 0.0001); reductions in patient-reported missed care and nurses' walking distances were not significant. Qualitative themes included: (1) inconsistent expectations (perceptions about potential vs actual functionality and benefits of the technology); (2) decisional conflict between managers and end-user nurses (discordance between governance decisions and clinical operations; 30% of beds were closed and six of the eight trained nurse 'super-users' were moved from the pilot ward); and (3) workflow effects (ergonomic set-up of the digital interface). This study highlights the complex challenges of implementing and examining the effects of technology to support nursing care. Shared understanding of the technology goals and project scope in relation to nursing care and flexible and adaptive project and contingency planning are fundamental considerations. Complexity, unpredictability and uncertainty of 'usual business' are common confounders in acute hospital settings.
机构:
Case Western Reserve Univ, Sch Med, Dept Epidemiol & Biostat, Cleveland, OH 44106 USACase Western Reserve Univ, Sch Med, Dept Epidemiol & Biostat, Cleveland, OH 44106 USA
Carter, Rebecca R.
Montpetite, Michelle M.
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机构:
Interprofess Improvement Res Educ & Clin Ctr, Cleveland, OH USACase Western Reserve Univ, Sch Med, Dept Epidemiol & Biostat, Cleveland, OH 44106 USA
Montpetite, Michelle M.
Jump, Robin L. P.
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机构:
Geriatr Res Educ & Clin Ctr, Cleveland, OH USA
Louis Stokes Cleveland Dept Vet Affairs Med Ctr, Ctr Innovat, Cleveland, OH USA
Case Western Reserve Univ, Dept Med, Div Infect Dis & HIV Med, Cleveland, OH 44106 USACase Western Reserve Univ, Sch Med, Dept Epidemiol & Biostat, Cleveland, OH 44106 USA
机构:
Mem Univ Newfoundland, Fac Nursing, 174 Patrick St, St John, NF A1C 5C4, CanadaMem Univ Newfoundland, Fac Nursing, 174 Patrick St, St John, NF A1C 5C4, Canada
Younas, Ahtisham
Pedersen, Maria
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机构:
Univ Coll, Dept Nursing & Nutr, Fac Hlth, Copenhagen, DenmarkMem Univ Newfoundland, Fac Nursing, 174 Patrick St, St John, NF A1C 5C4, Canada
Pedersen, Maria
Tayaben, Jude Laoagan
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机构:
Benguet State Univ, Coll Nursing, La Trinidad, PhilippinesMem Univ Newfoundland, Fac Nursing, 174 Patrick St, St John, NF A1C 5C4, Canada