The document summarizes a statewide study conducted in Texas to evaluate nurses' satisfaction with electronic health records (EHRs). Over 1,000 nurses responded to an online survey that assessed EHR usability and meaningful use using the Clinical Information System Implementation Evaluation Scale and a Meaningful Use Maturity-Sensitive Index. Results showed that EHR maturity levels and nurse age significantly influence satisfaction. Qualitative analysis of open-ended responses provided further insight into nurses' experiences. Recommendations will inform strategies to improve EHR satisfaction.
Transforming Nursing and Healthcare through TechnologyDiscussion.docxturveycharlyn
Transforming Nursing and Healthcare through Technology
Discussions
1. Electronic Health Records
Electronic health records (EHRs) are at the center stage of the effort to improve health care quality and control costs. In addition to allowing medical practitioners to access and record clinical documentation at much faster rates, EHRs are also positively influencing care delivery and nurse-patient interaction. Yet despite the potential benefits of EHRs, their implementation can be a formidable task that has broad-reaching implications for an entire health care organization.
In this Discussion, you appraise strategies for obtaining the benefits and overcoming the challenges of implementing and using electronic health records.
To prepare
Review the implementation of EHRs in an organization. Reflect on the various approaches used.
If applicable, consider your own experiences with implementing EHRs. What were some positive aspects of the implementation? What suggestions would you make to improve the process?
Reflect on the reactions of others during the implementation process. Were concerns handled effectively?
If you have not had any experiences with an EHR implementation, talk to someone who has and get his or her feedback on the experience.
Search and indicate examples of effective and poor implementation of EHRs.
RESOURCES
Required Readings
McGonigle, D., & Mastrian, K. G. (2015). Nursing informatics and the foundation of knowledge (3rd ed.). Burlington, MA: Jones and Bartlett Learning.
Chapter 15, “The Electronic Health Record and Clinical Informatics”
This chapter describes the crucial parts of an electronic health record system and explores the benefits of implementing one.
Bates, D. W. (2010). Getting in step: Electronic health records and their role in care coordination. Journal of General Internal Medicine, 25(3), 174–176.
The author of this editorial critically analyzes current applications of electronic health records (EHRs) and their impact on cost, quality, and safety of health care delivery. The author describes a study on the use of vendor-developed EHRs in clinical practice settings, the results of which pinpointed the benefits and drawbacks of EHRs.
Cresswell, K., & Sheikh, A. (2009). The NHS Care Record Service: Recommendations from the literature on successful implementation and adoption. Informatics in Primary Care, 17(3), 153–160.
This article defines the United Kingdom’s National Health Service’s Care Record Service (NHS CRS) as a standard electronic health record system. The article describes the challenges associated with implementing this new information technology and provides recommendations for overcoming those challenges.
Fickenscher, K., & Bakerman, M. (2011). Change management in health care IT. Physician Executive, 37(2), 64–67.
This article offers strategies for health care leaders to successfully implement change programs in their organizations, especially with regard to the new standards for electronic health ...
Discussions1.Electronic Health RecordsElectronic healt.docxlefrancoishazlett
Discussions
1.
Electronic Health Records
Electronic health records (EHRs) are at the center stage of the effort to improve health care quality and control costs. In addition to allowing medical practitioners to access and record clinical documentation at much faster rates, EHRs are also positively influencing care delivery and nurse-patient interaction. Yet despite the potential benefits of EHRs, their implementation can be a formidable task that has broad-reaching implications for an entire health care organization.
In this Discussion, you appraise strategies for obtaining the benefits and overcoming the challenges of implementing and using electronic health records.
To prepare
Review the implementation of EHRs in an organization. Reflect on the various approaches used.
If applicable, consider your own experiences with implementing EHRs. What were some positive aspects of the implementation? What suggestions would you make to improve the process?
Reflect on the reactions of others during the implementation process. Were concerns handled effectively?
If you have not had any experiences with an EHR implementation, talk to someone who has and get his or her feedback on the experience.
Search and indicate examples of effective and poor implementation of EHRs.
RESOURCES
Required Readings
McGonigle, D., & Mastrian, K. G. (2015). Nursing informatics and the foundation of knowledge (3rd ed.). Burlington, MA: Jones and Bartlett Learning.
Chapter 15, “The Electronic Health Record and Clinical Informatics”
This chapter describes the crucial parts of an electronic health record system and explores the benefits of implementing one.
Bates, D. W. (2010). Getting in step: Electronic health records and their role in care coordination. Journal of General Internal Medicine, 25(3), 174–176.
The author of this editorial critically analyzes current applications of electronic health records (EHRs) and their impact on cost, quality, and safety of health care delivery. The author describes a study on the use of vendor-developed EHRs in clinical practice settings, the results of which pinpointed the benefits and drawbacks of EHRs.
Cresswell, K., & Sheikh, A. (2009). The NHS Care Record Service: Recommendations from the literature on successful implementation and adoption. Informatics in Primary Care, 17(3), 153–160.
This article defines the United Kingdom’s National Health Service’s Care Record Service (NHS CRS) as a standard electronic health record system. The article describes the challenges associated with implementing this new information technology and provides recommendations for overcoming those challenges.
Fickenscher, K., & Bakerman, M. (2011). Change management in health care IT. Physician Executive, 37(2), 64–67.
This article offers strategies for health care leaders to successfully implement change programs in their organizations, especially with regard to the new standards for electronic health records (EHRs). The article provide.
WK1 Main Post Clark Adrienne In 1992, Nursing Informatics was.docxericbrooks84875
WK1 Main Post Clark Adrienne
In 1992, Nursing Informatics was recognized as a specialty by the American Nurse Association (ANA). Nursing continues to be one of the most demanding and critical fields in medicine. Being a nurse for over 22 years, it wasn’t until the last 16 years that I had the opportunity to excel in various nursing positions which involved data mining via electronic medical records or some part of nursing informatics process. Technology in health care is increasingly becoming an integral component of the U.S. health care delivery system. Nurses, through their role in the delivery of patient care, have a pivotal role in technology deployment, maintenance, and evolution. Although nurses are becoming involved in technology in health care, the specific roles are diverse, and more nurses are expressing an interest in nursing informatics according to Ericksen (2009). Of those many roles, nursing informatics has become one of those key roles. It became my goal to learn more about nursing informatics to improve the safety and efficiency of patient care via electronic medical records documentation.
Key Functional Areas and Relevance
According to the ANA, there are nine functional area of nursing informatics (2015). During my military career, I have gained experiences via the various functional roles of informatics nursing all except the “research and evaluation” according to ANA (2015). For example, I held many nursing leadership and management positions as a utilization/case/disease manager, clinical director of operations, health care integrator, and medical management director and inspection compliance officer. For the purpose of this discussion, the two key functional areas of informatics were found to be relevant to my interest and nursing career is leadership and compliance.
When I think of the roles and responsibilities of a nurse leader, who plays a significant role in advocating for nursing informatics “interpersonal collaboration” comes to mind in developing technology (ANA, 2015). Also, nurse informatics, leaders need to communicate clearly and concisely and to structure their ideas strategically in line with the organization’s mission and goals (ANA, 2015). Together with nurse frontline managers and clinical leaders, and nurse informatics leaders help set the organization’s direction and objectives. Also, these teams strive for consistent practices and accountability across an organization. Also,
In 2005, I was stationed overseas as a new Director of Quality. Upon my arrival, there was an influx of medication errors approximately 45 reported via The Patient Safety Reporting System (PSRS) all within year to include three sentinel events. There were a few nurses' names repeated via PSRS. The Chief Nurse (CN) was in the process to submit paperwork to have their license suspended. Also, the next step was to have them remove from the military if there was no progress within a year. In preparation for my new job, I atten.
Transforming Nursing and Healthcare through TechnologyDiscussion.docxturveycharlyn
Transforming Nursing and Healthcare through Technology
Discussions
1. Electronic Health Records
Electronic health records (EHRs) are at the center stage of the effort to improve health care quality and control costs. In addition to allowing medical practitioners to access and record clinical documentation at much faster rates, EHRs are also positively influencing care delivery and nurse-patient interaction. Yet despite the potential benefits of EHRs, their implementation can be a formidable task that has broad-reaching implications for an entire health care organization.
In this Discussion, you appraise strategies for obtaining the benefits and overcoming the challenges of implementing and using electronic health records.
To prepare
Review the implementation of EHRs in an organization. Reflect on the various approaches used.
If applicable, consider your own experiences with implementing EHRs. What were some positive aspects of the implementation? What suggestions would you make to improve the process?
Reflect on the reactions of others during the implementation process. Were concerns handled effectively?
If you have not had any experiences with an EHR implementation, talk to someone who has and get his or her feedback on the experience.
Search and indicate examples of effective and poor implementation of EHRs.
RESOURCES
Required Readings
McGonigle, D., & Mastrian, K. G. (2015). Nursing informatics and the foundation of knowledge (3rd ed.). Burlington, MA: Jones and Bartlett Learning.
Chapter 15, “The Electronic Health Record and Clinical Informatics”
This chapter describes the crucial parts of an electronic health record system and explores the benefits of implementing one.
Bates, D. W. (2010). Getting in step: Electronic health records and their role in care coordination. Journal of General Internal Medicine, 25(3), 174–176.
The author of this editorial critically analyzes current applications of electronic health records (EHRs) and their impact on cost, quality, and safety of health care delivery. The author describes a study on the use of vendor-developed EHRs in clinical practice settings, the results of which pinpointed the benefits and drawbacks of EHRs.
Cresswell, K., & Sheikh, A. (2009). The NHS Care Record Service: Recommendations from the literature on successful implementation and adoption. Informatics in Primary Care, 17(3), 153–160.
This article defines the United Kingdom’s National Health Service’s Care Record Service (NHS CRS) as a standard electronic health record system. The article describes the challenges associated with implementing this new information technology and provides recommendations for overcoming those challenges.
Fickenscher, K., & Bakerman, M. (2011). Change management in health care IT. Physician Executive, 37(2), 64–67.
This article offers strategies for health care leaders to successfully implement change programs in their organizations, especially with regard to the new standards for electronic health ...
Discussions1.Electronic Health RecordsElectronic healt.docxlefrancoishazlett
Discussions
1.
Electronic Health Records
Electronic health records (EHRs) are at the center stage of the effort to improve health care quality and control costs. In addition to allowing medical practitioners to access and record clinical documentation at much faster rates, EHRs are also positively influencing care delivery and nurse-patient interaction. Yet despite the potential benefits of EHRs, their implementation can be a formidable task that has broad-reaching implications for an entire health care organization.
In this Discussion, you appraise strategies for obtaining the benefits and overcoming the challenges of implementing and using electronic health records.
To prepare
Review the implementation of EHRs in an organization. Reflect on the various approaches used.
If applicable, consider your own experiences with implementing EHRs. What were some positive aspects of the implementation? What suggestions would you make to improve the process?
Reflect on the reactions of others during the implementation process. Were concerns handled effectively?
If you have not had any experiences with an EHR implementation, talk to someone who has and get his or her feedback on the experience.
Search and indicate examples of effective and poor implementation of EHRs.
RESOURCES
Required Readings
McGonigle, D., & Mastrian, K. G. (2015). Nursing informatics and the foundation of knowledge (3rd ed.). Burlington, MA: Jones and Bartlett Learning.
Chapter 15, “The Electronic Health Record and Clinical Informatics”
This chapter describes the crucial parts of an electronic health record system and explores the benefits of implementing one.
Bates, D. W. (2010). Getting in step: Electronic health records and their role in care coordination. Journal of General Internal Medicine, 25(3), 174–176.
The author of this editorial critically analyzes current applications of electronic health records (EHRs) and their impact on cost, quality, and safety of health care delivery. The author describes a study on the use of vendor-developed EHRs in clinical practice settings, the results of which pinpointed the benefits and drawbacks of EHRs.
Cresswell, K., & Sheikh, A. (2009). The NHS Care Record Service: Recommendations from the literature on successful implementation and adoption. Informatics in Primary Care, 17(3), 153–160.
This article defines the United Kingdom’s National Health Service’s Care Record Service (NHS CRS) as a standard electronic health record system. The article describes the challenges associated with implementing this new information technology and provides recommendations for overcoming those challenges.
Fickenscher, K., & Bakerman, M. (2011). Change management in health care IT. Physician Executive, 37(2), 64–67.
This article offers strategies for health care leaders to successfully implement change programs in their organizations, especially with regard to the new standards for electronic health records (EHRs). The article provide.
WK1 Main Post Clark Adrienne In 1992, Nursing Informatics was.docxericbrooks84875
WK1 Main Post Clark Adrienne
In 1992, Nursing Informatics was recognized as a specialty by the American Nurse Association (ANA). Nursing continues to be one of the most demanding and critical fields in medicine. Being a nurse for over 22 years, it wasn’t until the last 16 years that I had the opportunity to excel in various nursing positions which involved data mining via electronic medical records or some part of nursing informatics process. Technology in health care is increasingly becoming an integral component of the U.S. health care delivery system. Nurses, through their role in the delivery of patient care, have a pivotal role in technology deployment, maintenance, and evolution. Although nurses are becoming involved in technology in health care, the specific roles are diverse, and more nurses are expressing an interest in nursing informatics according to Ericksen (2009). Of those many roles, nursing informatics has become one of those key roles. It became my goal to learn more about nursing informatics to improve the safety and efficiency of patient care via electronic medical records documentation.
Key Functional Areas and Relevance
According to the ANA, there are nine functional area of nursing informatics (2015). During my military career, I have gained experiences via the various functional roles of informatics nursing all except the “research and evaluation” according to ANA (2015). For example, I held many nursing leadership and management positions as a utilization/case/disease manager, clinical director of operations, health care integrator, and medical management director and inspection compliance officer. For the purpose of this discussion, the two key functional areas of informatics were found to be relevant to my interest and nursing career is leadership and compliance.
When I think of the roles and responsibilities of a nurse leader, who plays a significant role in advocating for nursing informatics “interpersonal collaboration” comes to mind in developing technology (ANA, 2015). Also, nurse informatics, leaders need to communicate clearly and concisely and to structure their ideas strategically in line with the organization’s mission and goals (ANA, 2015). Together with nurse frontline managers and clinical leaders, and nurse informatics leaders help set the organization’s direction and objectives. Also, these teams strive for consistent practices and accountability across an organization. Also,
In 2005, I was stationed overseas as a new Director of Quality. Upon my arrival, there was an influx of medication errors approximately 45 reported via The Patient Safety Reporting System (PSRS) all within year to include three sentinel events. There were a few nurses' names repeated via PSRS. The Chief Nurse (CN) was in the process to submit paperwork to have their license suspended. Also, the next step was to have them remove from the military if there was no progress within a year. In preparation for my new job, I atten.
A Nurse’s Role in the Systems Development Life CycleWhile the proc.docxJospehStull43
A Nurse’s Role in the Systems Development Life Cycle
While the process of developing and implementing a health information technology system may seem overwhelming at first, the systems development life cycle (SDLC) provides organizations with a framework to deliver efficient and effective information systems. Though the SDLC is a common overarching structure for implementing information systems, it is not a one-size-fits-all process. In fact, there are a multitude of approaches that can be used to guide the systems development life cycle. The SDLC approach that is most appropriate for a particular organization will be highly contextual and subject to organization-specific differences.
This week prompts you to analyze the process of selecting an appropriate health information technology and then evaluate techniques that positively impact the steps of the systems development life cycle in an EHR implementation. You also determine what barriers might occur at each stage and how these could be overcome.
Learning Objectives
Students will:
Analyze how a nurse can contribute to each stage of the systems development life cycle
Photo Credit: Jose Luis Pelaez Inc]/[Brand X Pictures]/Getty ImagesCredit
Learning Resources
Note:
To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
McGonigle, D., & Mastrian, K. G. (2015).
Nursing informatics and the foundation of knowledge
(3rd ed.). Burlington, MA: Jones and Bartlett Learning.
Chapter 10, “Systems Development Life Cycle: Nursing Informatics and Organizational Decision Making”
This chapter explains the systems development life cycle and explores various methods of applying it. The chapter also examines the importance of interoperability in implementing HITECH.
Chapter 11, “Administrative Information Systems”
This chapter provides an overview of agency-based health information systems. The text also details how administrators can use core business systems in their practice.
Boswell, R. A. (2011). A physician group’s movement toward electronic health records: A case study using the transtheoretical model for organizational change.
Consulting Psychology Journal: Practice and Research, 63
(2), 138–148.
Retrieved from the Walden Library databases.
The authors of this article present a case study on an EHR implementation in a multispecialty physician group. The case study attempts to determine actions that promote successful EHR implementation and the pros and cons of implementation.
Hsiao, J., Chang, H., & Chen, R. (2011).A study of factors affecting acceptance of hospital information systems: A nursing perspective.
Journal of Nursing Research, 19
(2), 150–160.
Retrieved from the Walden Library databases.
The focus of this article is to determine what factors are most important in predicting the acceptance of new health information technology. The results of the study indicated .
The Perception of Emergency Medical Staff on the Use of Electronic Patient Cl...ijtsrd
Background The electronic recording of patient information in ambulance services has provided healthcare professionals with the ability to send patient data to their GP or other relevant services electronically. It is critical to comprehend how paramedics view and adjust to electronic platforms as technology continues to advance. Objective To identify the facilitators and barriers EMS staff encounter when using e PCR. To explore the overall perception of EMS staff towards the utilization of e PCR in EMS settings. Method Four databases were searched including PubMed, Scopus, Medline and Science Direct. Result All 11 publications were evaluated for qualitative data and the publication was found to be of fair or good quality. Studies investigating the perception of staff found mixed perceptions. The search generated a total of 1365 potential articles. After the initial screening process, 229 duplicate records were removed Out of the remaining 1136 papers, 1079 were excluded as they did not meet the selection criteria the title, abstract, and keywords. Of the remaining 57 papers, a full text screening eliminated 46 for the study design quantitative studies n=22 , no perception of staff documented n=19 and no full text available n=5 . Thus, 11 papers that met the inclusion criteria were selected for final analysis. The risk of bias was quantified using CASP. A qualitative synthesis was conducted and three major themes emerged Facilitators, Barriers and overall perception of staff. Conclusion This systematic review found that EMS staff hold complex and diverse views on e PCR systems. While several facilitators and barriers impact e PCR adoption, it has been found that e PCR has the potential to enhance documentation, communication, data driven decision making and finally the ability to improve overall patient care quality. To ensure successful adoption, addressing technical issues, data security and training requirements and organisational barriers is important. Reshma Joe | Jomin George "The Perception of Emergency Medical Staff on the Use of Electronic Patient Clinical Records Systems in Emergency Medical Service: A Systematic Review" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-8 | Issue-1 , February 2024, URL: https://www.ijtsrd.com/papers/ijtsrd62365.pdf Paper Url: https://www.ijtsrd.com/medicine/other/62365/the-perception-of-emergency-medical-staff-on-the-use-of-electronic-patient-clinical-records-systems-in-emergency-medical-service-a-systematic-review/reshma-joe
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j o u r n a l h o m e p a g e : w w w . i j m i j o u r n a l . c o m
ransitioning from a computerized provider order entry and
aper documentation system to an electronic health record:
xpectations and experiences of hospital staff
ric S. Kirkendall a,b,c,∗, Linda M. Goldenhar c, Jodi L. Simon c,
erek S. Wheeler d, S. Andrew Spooner a,b
Division of Hospital Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
Division of Biomedical Informatics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
James M. Anderson Center for Health Systems Excellence, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
Division of Critical Care Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
r t i c l e i n f o
rticle history:
eceived 6 September 2012
eceived in revised form
1 July 2013
ccepted 7 August 2013
eywords:
lectronic health records
edical informatics
uality of healthcare
atient safety
ser satisfaction
a b s t r a c t
Objectives: To examine healthcare worker’s perceptions, expectations, and experiences
regarding how work processes, patient-related safety, and care were affected when a qua-
ternary care center transitioned from one computerized provider order entry (CPOE) system
to a full electronic health record (EHR).
Methods: The I-SEE survey was administered prior to and 1-year after transition in sys-
tems. The construct validity and reliability of the survey was assessed within the current
population and also compared to previously published results. Pre- and 1-year post-
implementation scale means were compared within and across time periods.
Results: The majority of respondents were nurses and personnel working in the acute care
setting. Because a confirmatory factor analysis indicated a lack of fit of our data to the I-SEE
survey’s 5-factor structure, we conducted an exploratory factor analysis that resulted in a
7-factor structure which showed better reliability and validity. Mean scores for each factor
indicated that attitudes and expectations were mostly positive and score trends over time
were positive or neutral. Nurses generally had less positive attitudes about the transition
than non-nursing respondents, although the difference diminished after implementation.
Conclusions: Findings demonstrate that the majority of responding staff were generally pos-
itive about transitioning from CPOE system to a full electronic health record (EHR) and
understood the goals of doing so, with overall improved ratings over time. In addition, the
I-SEE survey, when modified based on our population, was useful for assessing patient care
and safety related expectations and experiences during the transition from one CPOE system
to an EHR.
∗ Corresponding author at: Divisi ...
Discussion 4Angela Brooks In reviewing the researchers’ arti.docxduketjoy27252
Discussion 4
Angela Brooks
In reviewing the researchers’ article regarding user satisfaction, the authors conducted a survey to gather expectations for using a clinical information system (Karimia, Poo, and Tan, 2015). The researchers noted how different responsibilities are responsible for utilizing information systems for various functions. They examined the link between user satisfaction and motivation to understand how to use the electronic medical records system. There seems to be a link between satisfaction and the ease of use. As the article demonstrated, the success of information systems are dependent on how the users view the product.
It is important that information systems meet the needs of users. Expectations for satisfaction should partly be dependent on the training that is provided for the health information system. If a staff is thoroughly trained on a system, it could contribute to motivation and make it easier for the staff to accept. However, if a system is not user friendly, it may make it difficult for users to be satisfied. Further, improvements to systems can also help a user’s attitude to improve and slowly reach an acceptance level.
Reference
Karimia, F., Poo, D., and Tan, Y. (2015). Clinical information systems end user satisfaction: The expectations and needs congruencies effects. Journal of Biomedical Informatics, 53:342–354. Retrieved from: http://www.sciencedirect.com/science/article/pii/S1532046414002731
Reply to Thread
End-User Satisfaction of Health Information Systems
Lisa Quinonez
The attitude of the users and their continuance to use an information systems is closely linked with their satisfaction with the system. Therefore, making investment in clinical information systems should put the end user into consideration and their satisfaction. Cognitive framework is therefore essential to help in identifying the clinicians’ satisfaction information. Using the disconfirmation paradigm as the core of the framework is great since it helps in examining the relationship between throughput times, expectations and patient satisfaction. By using the expectations and needs congruence models and perceived performance as the basis of comparing the models helps in achieving the objective of the experiment.
The response rates of the experiment was high which helps to validate the results of the experiment. The fact that it the participants were drawn from public hospitals portrays the actual situation on the ground. The survey methodology helps to empirically validate the proposed research model. To analyze the data, the partial least squares method was used. From the experiment, the results show that clinician’s satisfaction is mostly influenced by the perceived CIS performance. This is closely followed by doctor’s expectations congruence. The results of this research dispel previous findings which indicate that nurses’ expectations and expectations congruence do not show a significant effect on .
February 10, 2011 BDPA Charlotte Program meeting.
Presented by:
Karen D. Hill, RHIA
Recruitment/Placement Specialist
ONC HIT Grant
Health Sciences Division
Central Piedmont Community College
Health Information Technology Workforce Development Program
Central Piedmont Community College
Assignment 2 Complementary Partners Imagine you are working wit.docxsalmonpybus
Assignment 2: Complementary Partners
Imagine you are working with a partner to plan and host a workshop on leadership. There will be 100 people attending. Within this assignment you will be creating a document that discusses the main components of leadership and corporate culture.
Write a three to five (3-5) page paper in which you:
1. Address a key leadership trait that can assist in managing conflict.
2. Discuss a tool or strategy a leader can adopt for improving communication within the organization.
3. Describe some methods for motivating employees and improving behaviors within the workplace.
4. Format your assignment according to the following formatting requirements:
a. This course requires use of APA format.
The specific course learning outcomes associated with this assignment are:
· Describe the primary functions of management (planning, organizing, leading, controlling) and the associated skills, tools, and theoretical approaches that can be used to accomplish these functions.
· Explain the principal theories of leadership and motivation, and describe the fundamental considerations in managing and motivating individual and group behavior.
· Describe actions to improve communications, manage conflict, develop strong organizational culture, and improve the ethical behavior in organizations.
· Use technology and information resources to research issues in management concepts.
· Write clearly and concisely about management concepts using proper writing mechanics.
Introduction to Information Technology—Role in Nursing and Healthcare
In this module, we begin with an introduction to information technology and the management of information. The readings in this module identify the many areas in healthcare in which information technology is used. The fundamental of healthcare delivery is an important start to our course. Information technology is used in such healthcare facilities as ambulatory care, acute care, and subacute care. The different methods and means each healthcare facility uses and manages information technology is outlined in our readings. Healthcare providers such as direct care providers, clinical allied professionals, and other organizations (i.e., American Medical Association, American Nurses Association) all use technology to guide delivery of care, information, and manage these deliveries for various reasons (McGonigle & Mastrian, 2015).
Introduction
As an information-intensive profession, nursing continues to use information technology in healthcare. Nurses use information in applying knowledge to problems, and acting with wisdom forming the basis of the professional of nursing. The availability of this information in caring for patients continues to grow for nurses and allows for increased accessibility, accuracy, and timeliness in caring for patients. The information age is here for nursing and the U.S. healthcare system (McGonigle & Mastrian, 2015). In this module, an introduction to information technology (IT), .
Health Information Systems Utilization: A Comparison of Extent and Magnitude ...AJHSSR Journal
ABSTRACT: Health information systems (HISs) are critical tools that have been widely adopted and
implemented in healthcare settings around the world, intending to improve the quality of healthcare services
(OHSs) delivered. However, it is the extent and magnitude of HISs utilization that seem to guarantee
improvement in the quality of health care. The study explored the extent to which HISs have been utilized in
selected public and private health facilities (PPHFs) in Dar es Salaam, Tanzania, and the determinants of its
utilization. A descriptive cross-sectional design was employed to collect data using the Kobo Collect survey tool
from 140 respondents and 12 key informants. Descriptive statistics (frequencies and percentages), Inferential
statistics (Pearson chi-square tests), and Linear regression analyses were employed to analyse data. The analysis
revealed that private ownership has a higher utilization rate of HIS (61.4%) compared to public ownership
(38.6%). Moreover, perceived ease of use and perceived usefulness were significant predictors of actual use of
the system, suggesting that users who found the system easy to use and useful were more likely to use it. In
conclusion, the utilization of HIS in Tanzania seems to be influenced by various factors, including ownership
type.
KEYWORDS: Determinants of Health Information Systems utilization, Health Information Systems, Health
Information Systems Utilization, Private Health Facilities, Public Health Facilities
Plenary presentation at the first EHR Summit of the UP Manila Medical Informatics Unit and the Philippine Medical Informatics Society, 10 Nov 2019. Philippine Heart Center.
Adoption of Integrated Healthcare Information System in Nairobi County: Kenya...Editor IJCATR
Health care information systems are aimed at facilitating the smooth running and interoperability of the health care
delivery processes to ensure efficiency and effectiveness; however, the complexity, heterogeneity and diversity of the health care
sector especially in Kenya poses serious challenges especially in relation to integration of the systems. There is a large disconnect
between the public and private health care delivery systems characterized by fragmentation of services, locally within hospitals
(among primary, secondary and tertiary health care settings) and across different health care centers. This research is aimed at
examining the adoption of integrated healthcare information system in Nairobi County; Kenyatta National Hospital represents the
public sector and The Mater Hospital the private sector. A sample size of 100 users on information system from the two hospitals
picked from the primary secondary and tertiary levels were selected and questionnaires administered to them. Data was analyzed
through descriptive statistics with the aid of SPSS. The results of the study indicated that there was a huge disparity between
healthcare information system adoption in the public and private sectors with the private sector’s adoption being at an advanced
stage. The major barriers to adoption including social political barriers, financial constraints and technical/technological barriers
also presented.
A Nurse’s Role in the Systems Development Life CycleWhile the proc.docxJospehStull43
A Nurse’s Role in the Systems Development Life Cycle
While the process of developing and implementing a health information technology system may seem overwhelming at first, the systems development life cycle (SDLC) provides organizations with a framework to deliver efficient and effective information systems. Though the SDLC is a common overarching structure for implementing information systems, it is not a one-size-fits-all process. In fact, there are a multitude of approaches that can be used to guide the systems development life cycle. The SDLC approach that is most appropriate for a particular organization will be highly contextual and subject to organization-specific differences.
This week prompts you to analyze the process of selecting an appropriate health information technology and then evaluate techniques that positively impact the steps of the systems development life cycle in an EHR implementation. You also determine what barriers might occur at each stage and how these could be overcome.
Learning Objectives
Students will:
Analyze how a nurse can contribute to each stage of the systems development life cycle
Photo Credit: Jose Luis Pelaez Inc]/[Brand X Pictures]/Getty ImagesCredit
Learning Resources
Note:
To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
McGonigle, D., & Mastrian, K. G. (2015).
Nursing informatics and the foundation of knowledge
(3rd ed.). Burlington, MA: Jones and Bartlett Learning.
Chapter 10, “Systems Development Life Cycle: Nursing Informatics and Organizational Decision Making”
This chapter explains the systems development life cycle and explores various methods of applying it. The chapter also examines the importance of interoperability in implementing HITECH.
Chapter 11, “Administrative Information Systems”
This chapter provides an overview of agency-based health information systems. The text also details how administrators can use core business systems in their practice.
Boswell, R. A. (2011). A physician group’s movement toward electronic health records: A case study using the transtheoretical model for organizational change.
Consulting Psychology Journal: Practice and Research, 63
(2), 138–148.
Retrieved from the Walden Library databases.
The authors of this article present a case study on an EHR implementation in a multispecialty physician group. The case study attempts to determine actions that promote successful EHR implementation and the pros and cons of implementation.
Hsiao, J., Chang, H., & Chen, R. (2011).A study of factors affecting acceptance of hospital information systems: A nursing perspective.
Journal of Nursing Research, 19
(2), 150–160.
Retrieved from the Walden Library databases.
The focus of this article is to determine what factors are most important in predicting the acceptance of new health information technology. The results of the study indicated .
The Perception of Emergency Medical Staff on the Use of Electronic Patient Cl...ijtsrd
Background The electronic recording of patient information in ambulance services has provided healthcare professionals with the ability to send patient data to their GP or other relevant services electronically. It is critical to comprehend how paramedics view and adjust to electronic platforms as technology continues to advance. Objective To identify the facilitators and barriers EMS staff encounter when using e PCR. To explore the overall perception of EMS staff towards the utilization of e PCR in EMS settings. Method Four databases were searched including PubMed, Scopus, Medline and Science Direct. Result All 11 publications were evaluated for qualitative data and the publication was found to be of fair or good quality. Studies investigating the perception of staff found mixed perceptions. The search generated a total of 1365 potential articles. After the initial screening process, 229 duplicate records were removed Out of the remaining 1136 papers, 1079 were excluded as they did not meet the selection criteria the title, abstract, and keywords. Of the remaining 57 papers, a full text screening eliminated 46 for the study design quantitative studies n=22 , no perception of staff documented n=19 and no full text available n=5 . Thus, 11 papers that met the inclusion criteria were selected for final analysis. The risk of bias was quantified using CASP. A qualitative synthesis was conducted and three major themes emerged Facilitators, Barriers and overall perception of staff. Conclusion This systematic review found that EMS staff hold complex and diverse views on e PCR systems. While several facilitators and barriers impact e PCR adoption, it has been found that e PCR has the potential to enhance documentation, communication, data driven decision making and finally the ability to improve overall patient care quality. To ensure successful adoption, addressing technical issues, data security and training requirements and organisational barriers is important. Reshma Joe | Jomin George "The Perception of Emergency Medical Staff on the Use of Electronic Patient Clinical Records Systems in Emergency Medical Service: A Systematic Review" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-8 | Issue-1 , February 2024, URL: https://www.ijtsrd.com/papers/ijtsrd62365.pdf Paper Url: https://www.ijtsrd.com/medicine/other/62365/the-perception-of-emergency-medical-staff-on-the-use-of-electronic-patient-clinical-records-systems-in-emergency-medical-service-a-systematic-review/reshma-joe
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i n t e r n a t i o n a l j o u r n a l o f m e d i c a l i n f o r m a t i c s 8 2 ( 2 0 1 3 ) 1037–1045
j o u r n a l h o m e p a g e : w w w . i j m i j o u r n a l . c o m
ransitioning from a computerized provider order entry and
aper documentation system to an electronic health record:
xpectations and experiences of hospital staff
ric S. Kirkendall a,b,c,∗, Linda M. Goldenhar c, Jodi L. Simon c,
erek S. Wheeler d, S. Andrew Spooner a,b
Division of Hospital Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
Division of Biomedical Informatics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
James M. Anderson Center for Health Systems Excellence, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
Division of Critical Care Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
r t i c l e i n f o
rticle history:
eceived 6 September 2012
eceived in revised form
1 July 2013
ccepted 7 August 2013
eywords:
lectronic health records
edical informatics
uality of healthcare
atient safety
ser satisfaction
a b s t r a c t
Objectives: To examine healthcare worker’s perceptions, expectations, and experiences
regarding how work processes, patient-related safety, and care were affected when a qua-
ternary care center transitioned from one computerized provider order entry (CPOE) system
to a full electronic health record (EHR).
Methods: The I-SEE survey was administered prior to and 1-year after transition in sys-
tems. The construct validity and reliability of the survey was assessed within the current
population and also compared to previously published results. Pre- and 1-year post-
implementation scale means were compared within and across time periods.
Results: The majority of respondents were nurses and personnel working in the acute care
setting. Because a confirmatory factor analysis indicated a lack of fit of our data to the I-SEE
survey’s 5-factor structure, we conducted an exploratory factor analysis that resulted in a
7-factor structure which showed better reliability and validity. Mean scores for each factor
indicated that attitudes and expectations were mostly positive and score trends over time
were positive or neutral. Nurses generally had less positive attitudes about the transition
than non-nursing respondents, although the difference diminished after implementation.
Conclusions: Findings demonstrate that the majority of responding staff were generally pos-
itive about transitioning from CPOE system to a full electronic health record (EHR) and
understood the goals of doing so, with overall improved ratings over time. In addition, the
I-SEE survey, when modified based on our population, was useful for assessing patient care
and safety related expectations and experiences during the transition from one CPOE system
to an EHR.
∗ Corresponding author at: Divisi ...
Discussion 4Angela Brooks In reviewing the researchers’ arti.docxduketjoy27252
Discussion 4
Angela Brooks
In reviewing the researchers’ article regarding user satisfaction, the authors conducted a survey to gather expectations for using a clinical information system (Karimia, Poo, and Tan, 2015). The researchers noted how different responsibilities are responsible for utilizing information systems for various functions. They examined the link between user satisfaction and motivation to understand how to use the electronic medical records system. There seems to be a link between satisfaction and the ease of use. As the article demonstrated, the success of information systems are dependent on how the users view the product.
It is important that information systems meet the needs of users. Expectations for satisfaction should partly be dependent on the training that is provided for the health information system. If a staff is thoroughly trained on a system, it could contribute to motivation and make it easier for the staff to accept. However, if a system is not user friendly, it may make it difficult for users to be satisfied. Further, improvements to systems can also help a user’s attitude to improve and slowly reach an acceptance level.
Reference
Karimia, F., Poo, D., and Tan, Y. (2015). Clinical information systems end user satisfaction: The expectations and needs congruencies effects. Journal of Biomedical Informatics, 53:342–354. Retrieved from: http://www.sciencedirect.com/science/article/pii/S1532046414002731
Reply to Thread
End-User Satisfaction of Health Information Systems
Lisa Quinonez
The attitude of the users and their continuance to use an information systems is closely linked with their satisfaction with the system. Therefore, making investment in clinical information systems should put the end user into consideration and their satisfaction. Cognitive framework is therefore essential to help in identifying the clinicians’ satisfaction information. Using the disconfirmation paradigm as the core of the framework is great since it helps in examining the relationship between throughput times, expectations and patient satisfaction. By using the expectations and needs congruence models and perceived performance as the basis of comparing the models helps in achieving the objective of the experiment.
The response rates of the experiment was high which helps to validate the results of the experiment. The fact that it the participants were drawn from public hospitals portrays the actual situation on the ground. The survey methodology helps to empirically validate the proposed research model. To analyze the data, the partial least squares method was used. From the experiment, the results show that clinician’s satisfaction is mostly influenced by the perceived CIS performance. This is closely followed by doctor’s expectations congruence. The results of this research dispel previous findings which indicate that nurses’ expectations and expectations congruence do not show a significant effect on .
February 10, 2011 BDPA Charlotte Program meeting.
Presented by:
Karen D. Hill, RHIA
Recruitment/Placement Specialist
ONC HIT Grant
Health Sciences Division
Central Piedmont Community College
Health Information Technology Workforce Development Program
Central Piedmont Community College
Assignment 2 Complementary Partners Imagine you are working wit.docxsalmonpybus
Assignment 2: Complementary Partners
Imagine you are working with a partner to plan and host a workshop on leadership. There will be 100 people attending. Within this assignment you will be creating a document that discusses the main components of leadership and corporate culture.
Write a three to five (3-5) page paper in which you:
1. Address a key leadership trait that can assist in managing conflict.
2. Discuss a tool or strategy a leader can adopt for improving communication within the organization.
3. Describe some methods for motivating employees and improving behaviors within the workplace.
4. Format your assignment according to the following formatting requirements:
a. This course requires use of APA format.
The specific course learning outcomes associated with this assignment are:
· Describe the primary functions of management (planning, organizing, leading, controlling) and the associated skills, tools, and theoretical approaches that can be used to accomplish these functions.
· Explain the principal theories of leadership and motivation, and describe the fundamental considerations in managing and motivating individual and group behavior.
· Describe actions to improve communications, manage conflict, develop strong organizational culture, and improve the ethical behavior in organizations.
· Use technology and information resources to research issues in management concepts.
· Write clearly and concisely about management concepts using proper writing mechanics.
Introduction to Information Technology—Role in Nursing and Healthcare
In this module, we begin with an introduction to information technology and the management of information. The readings in this module identify the many areas in healthcare in which information technology is used. The fundamental of healthcare delivery is an important start to our course. Information technology is used in such healthcare facilities as ambulatory care, acute care, and subacute care. The different methods and means each healthcare facility uses and manages information technology is outlined in our readings. Healthcare providers such as direct care providers, clinical allied professionals, and other organizations (i.e., American Medical Association, American Nurses Association) all use technology to guide delivery of care, information, and manage these deliveries for various reasons (McGonigle & Mastrian, 2015).
Introduction
As an information-intensive profession, nursing continues to use information technology in healthcare. Nurses use information in applying knowledge to problems, and acting with wisdom forming the basis of the professional of nursing. The availability of this information in caring for patients continues to grow for nurses and allows for increased accessibility, accuracy, and timeliness in caring for patients. The information age is here for nursing and the U.S. healthcare system (McGonigle & Mastrian, 2015). In this module, an introduction to information technology (IT), .
Health Information Systems Utilization: A Comparison of Extent and Magnitude ...AJHSSR Journal
ABSTRACT: Health information systems (HISs) are critical tools that have been widely adopted and
implemented in healthcare settings around the world, intending to improve the quality of healthcare services
(OHSs) delivered. However, it is the extent and magnitude of HISs utilization that seem to guarantee
improvement in the quality of health care. The study explored the extent to which HISs have been utilized in
selected public and private health facilities (PPHFs) in Dar es Salaam, Tanzania, and the determinants of its
utilization. A descriptive cross-sectional design was employed to collect data using the Kobo Collect survey tool
from 140 respondents and 12 key informants. Descriptive statistics (frequencies and percentages), Inferential
statistics (Pearson chi-square tests), and Linear regression analyses were employed to analyse data. The analysis
revealed that private ownership has a higher utilization rate of HIS (61.4%) compared to public ownership
(38.6%). Moreover, perceived ease of use and perceived usefulness were significant predictors of actual use of
the system, suggesting that users who found the system easy to use and useful were more likely to use it. In
conclusion, the utilization of HIS in Tanzania seems to be influenced by various factors, including ownership
type.
KEYWORDS: Determinants of Health Information Systems utilization, Health Information Systems, Health
Information Systems Utilization, Private Health Facilities, Public Health Facilities
Plenary presentation at the first EHR Summit of the UP Manila Medical Informatics Unit and the Philippine Medical Informatics Society, 10 Nov 2019. Philippine Heart Center.
Adoption of Integrated Healthcare Information System in Nairobi County: Kenya...Editor IJCATR
Health care information systems are aimed at facilitating the smooth running and interoperability of the health care
delivery processes to ensure efficiency and effectiveness; however, the complexity, heterogeneity and diversity of the health care
sector especially in Kenya poses serious challenges especially in relation to integration of the systems. There is a large disconnect
between the public and private health care delivery systems characterized by fragmentation of services, locally within hospitals
(among primary, secondary and tertiary health care settings) and across different health care centers. This research is aimed at
examining the adoption of integrated healthcare information system in Nairobi County; Kenyatta National Hospital represents the
public sector and The Mater Hospital the private sector. A sample size of 100 users on information system from the two hospitals
picked from the primary secondary and tertiary levels were selected and questionnaires administered to them. Data was analyzed
through descriptive statistics with the aid of SPSS. The results of the study indicated that there was a huge disparity between
healthcare information system adoption in the public and private sectors with the private sector’s adoption being at an advanced
stage. The major barriers to adoption including social political barriers, financial constraints and technical/technological barriers
also presented.
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
Biological screening of herbal drugs: Introduction and Need for
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Antifertility, Toxicity studies as per OECD guidelines
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
Introduction to AI for Nonprofits with Tapp NetworkTechSoup
Dive into the world of AI! Experts Jon Hill and Tareq Monaur will guide you through AI's role in enhancing nonprofit websites and basic marketing strategies, making it easy to understand and apply.
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
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NUR3165 SFCC Statewide Study to Assess Nurses Experience Review Article.docx
1. NUR3165 SFCC Statewide Study to Assess Nurses Experience Review
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Attachment PreviewCIN: Computers, Informatics, Nursing Issue: Volume 35(1), January
2017, p 18-28 Copyright: Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights
reserved. Publication Type: [FEATURES] DOI: 10.1097/CIN.0000000000000290 ISSN:
1538-2931 Accession: 00024665-201701000-00005 Keywords: Clinical decision support,
Electronic health records, Informatics, Meaning use, Nursing informatics competencies,
Satisfaction, Usability, Workflow Hide Cover [FEATURES]« Previous Article Table of
Contents Next Article » Statewide Study to Assess Nurses’ Experiences With Meaningful
Use-Based Electronic Health Records McBride, Susan PhD, RN-BC, CPHIMS, FAAN; Tietze,
Mari PhD, RN-BC, FHIMSS; Hanley, Mary Anne PhD, RN; Thomas, Laura PhD, RN, CNE
Author Information Author Affiliations: Texas Tech University Health Science Center, School
of Nursing, Lubbock (Dr McBride), Texas Woman’s University, College of Nursing, Dallas (Dr
Tietze); Sul Ross State University Rio Grand College, Alpine (Dr. Hanley); and Texas Tech
Health University Sciences Center, School of Nursing, Lubbock (Dr Thomas), Texas. The
authors have disclosed that they have no significant relationship with, or financial interest
in, any commercial companies pertaining to this article. Corresponding author: Mari Tietze,
PhD, RN-BC, FHIMSS, Texas Woman’s University, Houston J. and Florence A. Doswell College
of Nursing, T. Boone Pickens Institute of Health Sciences-Dallas Center, 5500 Southwestern
Medical Ave, Dallas, TX 75235 (mtietze@twu.edu). Abstract Nursing professionals are at the
frontline of the health information technology revolution. The Texas Nurses Association and
Texas Organization of Nurse Executives partnered to evaluate the changing health
technology environment in Texas, in particular the nurses’ satisfaction with the use of
clinical information systems. NUR3165 SFCC Statewide Study to Assess Nurses Experience
Review ArticleA descriptive exploratory study using the Clinical Information System
2. Implementation Evaluation Scale and a newly developed Demographic Survey and the
Meaningful Use Maturity-Sensitive Index, with a narrative component, was conducted in
2014 and 2015. Nurses across Texas received an electronic invitation to participate in the
survey, resulting in 1177 respondents. Exploratory factor analysis revealed that variables of
the Meaningful Use MaturitySensitive Index and Clinical Information System
Implementation Evaluation Scale show strong interrater reliability, with Cronbach’s [alpha]
scores of .889 and .881, respectively, and thereby inform the survey analysis, indicating and
explaining variations in regional and institutional trends with respect to satisfaction. For
example, the maturity of a clinical information system within an organization and age of the
nurse significantly influence the probability of nurse satisfaction (P < .05). Qualitative
analysis of nurses’ narratives further explained the nurses’ experiences. Recommendations
for future research and educational were identified. The healthcare industry is undergoing a
major transformation to establish an interoperable health information technology (HIT)
infrastructure to connect the nation with electronic health records (EHRs) and health
information exchanges (HIEs). This informatics revolution is affecting all aspects of the
nursing profession.1-3 With the passage of the Health Information Technology for
Economic and Clinical Health Act in 2009,3 the Texas Nurses Association (TNA) Board of
Directors formed an advisory committee to evaluate the changing health technology
environment and make recommendations to the TNA Board regarding steps needed to
prepare Texas nurses for the rapid uptake of technology in healthcare settings required by
this legislation. The TNA Board joined with the Texas Organization of Nurse Executives
(TONE) to create a statewide partnership with nursing leaders to address the impact of HIT
on nursing in the state of Texas. The TNA and TONE Boards formulated the TNA-TONE HIT
Task Force. In 2014, this task force became an official joint committee of both Boards, with
recognition of the importance of HIT to nursing practice and the importance of both
organizations partnering to address nursing impact. The TNA-TONE HIT committee was
charged with examining how Texas nurses were affected by newly implemented EHRs
across the state and to establish baseline measures of nurses’ satisfaction to inform
evidencebased improvement strategies. To accomplish this goal, a statewide study was
initiated to evaluate the perceptions of nurses about their clinical information systems
(CISs), defined as EHRs. The full intent of the study was to evaluate the nurses’ perspectives
related to satisfaction with the usability of the institutions’ CIS used in patient care delivery
across Texas. This information was intended to inform statewide efforts in Texas to
improve the use of HIT for nurses and other associated stakeholders. The purpose of this
article is to summarize the development of a statewide Texas HIT study, describe the
methods used, report the results of the study, and outline the next steps for a statewide
improvement effort to address Texas nurses’ satisfaction with their EHRs. Back to Top
BACKGROUND AND SIGNIFICANCE OF THE STUDY The quality of healthcare and patient
safety in the United States has become a national concern in recent years, motivated by the
release of several Institute of Medicine (IOM) reports. The first IOM report noted that
medical errors were a national public health problem.4 The same report suggested that
substantive improvements in information technology were necessary to support clinical
and administrative decision making about healthcare systems. A common theme in all of the
3. IOM reports is that broad safety and quality improvement efforts require the development
of innovative, electronic health information systems.4-6 Healthcare organizations in Texas
are in the process of adopting and integrating information systems to meet the
requirements of the Office of the National Coordinator (ONC).7 The goal is to move toward
universal adoption of CISs, achieve meaningful use (MU) of EHRs, and establish
interoperability through HIEs. With 73.2% of office-based physicians using a certified EHR
system, HIEs could provide a significant improvement in communication between providers
and hospitals. However, literature regarding the evaluation of the benefits that accrue from
the adoption of EHRs for nursing appears limited. For example, in a search of the major
electronic databases, the past 5 years yielded 44 articles using electronic health record as a
key term and the word nursing in the title. None of the articles systematically addressed
satisfaction.8-10 Within Texas, there has been little effort to systematically evaluate the
experience of nurses who use information technology. The role of information technology is
complex and dependent on the systems and processes in which it is embedded.
Furthermore, health information systems implementation is confounded by human factors
and barriers that impede user acceptance and use of the systems.11-13 If end users believe
that the technology is easy to use and is beneficial in supplying the information they need
for decision-making purposes, adoption has a higher likelihood of success. If end users
perceive there is no relative benefit of the new system compared with what had been
available to them in the past, it is reasonable to assume that adoption will be resisted.10,13
Two theoretical models for the successful implementation of information systems were
appraised. The DeLone and McLean Model of Information Systems Success used in a
number of information system evaluation studies identified three dimensions important to
systems success: system quality, information quality, and service quality.14 These
dimensions may be measured by user satisfaction, NUR3165 SFCC Statewide Study to
Assess Nurses Experience Review Articleintention to use, and measurable net benefits of
the system. The second model, Rogers’ innovation diffusion theory, identified constructs
about technology that influence adoption as well as aspects of the adopters and the
adoption process.15 In addition, the innovation diffusion theory considers organizational
factors that influence technology adoption.15,16 Attributes of technological innovation that
affect adoption of CISs, also known as EHRs include perceived relative advantages,
compatibility, complexity, trial-ability, benefits realization, adaptability, risk, task
performance improvement, and knowledge. Characteristics of individual adopters that
influence the adoption of innovation include tolerance of ambiguity, intellectual ability,
motivation, values, learning style, and organizational or social position.15 Given the relative
newness of the use of CISs, several instruments were considered. The Clinical Information
System Implementation Evaluation Scale (CISIES), developed by Gugerty et al,17 was one
that assesses user satisfaction across organizations and reflects attributes of technological
innovation. The instrument is sensitive to the adopter’s characteristics across organizations
in both formative and summative evaluations of CIS implementation. More details about the
CISIES will follow. Assessing end-user perceptions of specific aspects of system
functionality, usability, and usefulness is essential to identify approaches that can be used to
make strategic improvements in CIS adoption, implementation, and optimization of the
4. system. The objective of the TNA/TONE HIT study was to inform a strategy that improves
Texas nurses’ satisfaction with their EHRs. To accomplish this goal, baseline measures of
satisfaction were needed. Back to Top STUDY METHODS The statewide multiorganization
study was a descriptive and exploratory study to identify key issues with the current
deployment of EHRs in the practice setting and to identify characteristics associated with
satisfaction to inform improvements. To address this aim, several research questions
directed the design of the study: 1. What is the relationship between health setting
characteristics and the nurses’ satisfaction with their EHRs? 2. What is the relationship
between the nurses’ characteristics and the nurses’ satisfaction with their EHRs? 3. What is
the relationship between CIS characteristics and the nurses’ satisfaction with their EHRs? 4.
What are the themes and subthemes that emerge from the narrative comments (qualitative
data) by nurses about using their EHRs that may inform improvement strategies? The study
design was supported by multiple partners, including TNA, TONE, and the Texas Tech
University Health Sciences Center School of Nursing (TTUHSC SON). The TTUHSC provided
research oversight and the internal review board approval for the study. A research
subgroup consisted of TNA-TONE HIT committee members working with two principal
investigators to develop the study design, methods, data collection, and analysis processes.
Back to Top Sampling and Survey Response In this statewide study, nursing staff members,
who are end users of a CIS, employed by Texas healthcare organizations, represent the
study population, including RNs, APRNs, LVNs, and support staff such as nursing assistants.
The target population was derived from a representative sampling of nurses employed in
private, public, and federal acute care facilities and their associated ambulatory/episodic
care and long-term care units, referred to collectively as the healthcare organization (HCO).
To determine sample size, an a priori power analysis was conducted to ensure 0.8 power
and a Cronbach’s [alpha] of .05. A small effect size revealed the need for 1092
respondents.18 This sample size was deemed to provide adequate representation of
descriptive statistics and statistical modeling using logistic regression to examine factors
associated with predicting satisfaction. The TNA/TONE online survey was deployed
through an e- Opens a popup window mail sent to staff nurses from the chief nurse officer of
the HCO inviting voluntary and anonymous participation using a stratified sampling
method. The survey was launched statewide on September 23, 2014. The initial sampling
strategy yielded approximately 250 survey responses. An improved secondary sampling
strategy utilized a snowball approach with distribution of the invitation to participate, the
survey link, and communication of purpose through e-mails sent by TNA and TONE
leadership to the membership of both organizations. This secondary strategy resulted in
1177 total survey responses. NUR3165 SFCC Statewide Study to Assess Nurses Experience
Review ArticleFinal data analysis to inform the recommended strategies was reflective of
comprehensive responses from 987 participants. Figure 1 demonstrates the volume
increase from the initial launch in September 2014 Figure 1Opens a popup window Opens a
popup window and the revised sampling strategy that resulted in the total responses
concluding in February 2015. Back to Top STUDY DESIGN AND INSTRUMENTATION Two
instruments were used to meet the study objectives. The first of the instruments was the
Demographic Survey and EHR Meaningful Use Maturity-Sensitive Index (MUMSI) designed
5. by McBride and Tietze with a group of content experts.19 The second instrument was the
CISIES designed by Gugerty et al.17 Back to Top Demographic Survey The TNA/TONE
research subgroup members designed the Demographic Survey consisting of two sections.
The first section was composed of questions descriptive of key characteristics of each
participant such as practice setting, shift, and experience with computers. These
characteristics were used to control for differences in respondents and their respective
organizations. The second section of the Demographic Survey addressed the maturity of the
organization’s EHR with respect to federal guidelines for MU 20 and nursing use. Methods
to adjust for the maturity of the EHR are important to fully understand the nurses’
experiences, particularly given rapid deployment of EHRs to meet federal certification
guidelines across the state. The Demographic Survey was used to explore the relationships
between CISIES responses, the participant and institutional demographic characteristics
such as practice setting, shift, experience with computers, and type of institution, while
controlling for the maturity of the EHR in the institution. Back to Top Meaningful Use
Maturity-Sensitive Index The maturity of an EHR was defined as the level of sophistication
of the nurse’s knowledge and use of EHR in daily practice. The research subgroup explored
various mechanisms to evaluate the maturity of the EHR in an institution. The subgroup
decided to utilize the ONC’s Stage 1 MU measures as the model for capturing different levels
of functional status about the maturity of the EHR. This also reflected the status of MU
maturity within the state of Texas at the time the study was initiated. Content validity of the
MUMSI was established with a two-round Delphi method with quantitative instrument
design strategies defined by Lynn.21 The MUMSI was deployed within the demographic
information in the online survey. Figure 2 reflects a sample from the 24-item instrument
and the manner in which the questions were presented to the participants. The participants
were asked to indicate if the MU Figure 2Opens a popup window functionality was present
and used, present and not used, not present, or they did not know if the functionality was
present. Back to Top Clinical Information System Implementation Evaluation Scale Opens a
popup window Opens a popup window The CISIES is a 37-item survey designed to measure
the participants’ satisfaction with their CIS. The CISIES 17 uses response choices ranging
from strongly agree to strongly disagree on a six-point Likert scale. The survey has been
tested for reliability and validity and has a Cronbach’s [alpha] ranging from .94 to .96.17 In
addition to achieving many of the study goals, the research subgroup determined that the
CISIES provided the most robust data to inform academic and practice settings with plans
needed to address HIT use by nurses. Back to Top Combined Instrumentation of Clinical
Information System Implementation NUR3165 SFCC Statewide Study to Assess Nurses
Experience Review ArticleEvaluation Scale and Meaningful Use Maturity-Sensitive Index
Both the CISIES 17 and the MUMSI 19 yielded strong interrater reliability, with Cronbach’s
[alpha] scores of .881 and .889, respectively.22 Nunnally et al 23 indicated that .7 Opens a
popup Opens a popup window window to .8 was an acceptable [alpha] level. Additionally,
the CISIES and MUMSI were examined using an exploratory factor analysis. The subscales
identified within both the CISIES and the MUMSI can be used to detect further details Figure
3Opens a popup window that might inform improvement plans long-term. The initial
examination was performed to assure the research subgroup that there was no immediate
6. overlap in the variables explaining the CISIES and the MUMSI. Figure 3 reflects the
performance of these two surveys when combined and analyzed using an exploratory factor
analysis methodology. Note that the rectangles in Figure 3, although too difficult to
interpret, represent each of the items on the two instruments (for further details of the
factor analysis, contact the corresponding author). The research team draws the reader’s
attention to the patterns distinguished noting the cluster identified as MUMSI, CISIES, and
clinical decision support (CDS). Back to Top Qualitative Narrative Content Analysis An
open-ended question related to nurses’ experiences with the use of technology and EHRs in
the clinical setting was included with the survey to gain in-depth textual information from
the nurses beyond the constraints of the instruments utilized. The question was stated as
“We are interested in your feedback and anything we might not have covered, please
provide any additional information you care to provide.” Of the 1177 surveys completed,
344 respondents provided free text or narrative responses. NVIVO 19 (QSR International,
Doncaster, Victoria, Australia) was used to conduct a word frequency analysis. NUR3165
SFCC Statewide Study to Assess Nurses Experience Review ArticleThis analysis detected key
terms that could be easily dropped back into the quantitative data. This result did not fully
inform the improvement strategy, so further analysis of the qualitative data was needed.
These narratives were analyzed and coded for themes by the research subgroup. The
confidentiality of participants was maintained through use of an electronic survey
administration system designed and deployed by TTUHSC SON Information Technology
Department, which included a Secure Sockets Layer, a protocol that works through a
cryptographic system that secures a connection between a client and a server. An off-the-
shelf software was used to design the online survey including the demographic section, 24-
item MUMSI, and 37-item CISIES questionnaires. No attempt was made to identify nurse
respondents or their individual response data. The study received approvals for an exempt
study by the TTUHSC institutional review board. Back to Top STUDY FINDINGS Back to Top
Characteristics of the Study Population Of the total 1177 respondents, 987 responded to all
survey questions; of those respondents, 21.4% (n = 211) represented a rural setting and
78.5% (n = 772) an urban setting. Rural respondents practiced in acute care (57.4%),
ambulatory care (10.9%), long-term care (0.5%), and other care areas (30.8%). Urban
respondents practiced in acute care (55.2%), ambulatory care (12%), long-term care
(1.4%), and other care areas (31.2%). Overall, 68.3% of the respondents indicated that they
provide direct patient care and 31.7% indicated that they do not provide direct care. Sixty-
two percent (62.6%) identified their role as staff, 13.5% as a manager/director/supervisor,
and 23.9% reported as other. Men represented 8.7% of the sample, and women, 91.3%.
Race was predominantly white Caucasian at 83.6%, 5.6% Black/African American, and
other at 10.8%. Of the respondents, 19.4% indicated years in nursing as fewer than 5 years,
while 41% …NUR3165 SFCC Statewide Study to Assess Nurses Experience Review Article