Exploratory Factor Analysis for a Nursing Workaround Instrument in Korean and Interpretations of Statistical Decision Points

The use of workarounds by nurses is prevalent in clinical settings. Understanding how work processes are adjusted as a result of implementing an electronic medical record is important because of its impact on patient care. The purpose of this study was to conduct an exploratory factor analysis of a 20-item nursing workaround instrument translated into Korean. The responses from 104 nurses were analyzed. Examinations of sample size, factorability of a correlation matrix, the Kaiser-Meyer-Olkin value, the P value of Bartlett test of sphericity, anti-image correlation coefficients, and communality were acceptable to proceed with exploratory factor analysis. The original dimensionality of four groups was retained. However, the number of items loaded onto each group was reduced from five to three. These four factors explained 66% of the total variance between the items. Cronbach's alpha for the internal consistency reliability of the instrument was .70. The 12-item nursing workaround instrument was specific to an electronic medical record, which was the strongest point of the instrument. Further confirmatory factor analysis of this instrument is needed. This translated instrument is expected to contribute to the proliferation of studies examining nurses' workarounds related to the use of electronic medical records in Korean clinical settings, thereby improving clinical information systems for clinical practice.