2.50
Hdl Handle:
http://hdl.handle.net/10755/156812
Type:
Presentation
Title:
Evaluation of clinical information systems for nursing practice
Abstract:
Evaluation of clinical information systems for nursing practice
Conference Sponsor:Sigma Theta Tau International
Conference Year:1993
Conference Date:June 21 - 22, 1993
Author:Beebe, Michael, DNS/DNSc/DSN
P.I. Institution Name:Michael Beebe Consulting
Title:Consultant
The evaluation of software and graphical user inter-faces (GUI) intended for use by health care providers in clinical settings requires research methods yet to be adequately described in the literature. Conducting software and GUI evaluations for the clinical nursing environment requires education and skills taught in few educational institutions. If the introduction of a point-of-care clinical information system (CIS) is to be positive, the process of installation and enhancement of CIS software requires rigorous assessment/research methodologies. These methodologies involve complex interdependent interactions between end-users, developer, vendor, administrators, and evaluators to name a few.



For this study we evaluated one of the world's largest integrated CIS which is located in a 500 bed facility in the Northwest United States. The CIS has undergone continuous evolution and intense evaluation since going live in April 1992. During this time qualitative end-user surveys on software and GUI were longitudinal and cross-sectional with the responses falling into four broad categories: speed/ease of access to specific modules; access to the patient database; screen design; and visual prompts for health care providers. The suggestions themselves from all users seemed to fit into eight basic categories of: system management, system-wide functions, printing and batch processing, clinical notes, scrolling, patient-select screen design and medication/treatment sheets. Based on survey data the two most important factors on the depth and breadth of enhancements suggestions were end-user knowledge of information systems and nurses' clinical expertise areas.



Two different nurse-informatologists (neither of whom had been involved in the original design of the system) met with staff and administrators over the period of the evaluation process. Virtually all staff on all three shifts who use the CIS were visited by both evaluators. In general, staff were asked what they liked about the system, what they didn't like and what they would do to change the system to make it more functional for their needs. We found this open ended interview approach to be more useful than a paper questionnaire or closed-ended questioning. It was important to take into account staff computer literacy levels and familiarity with the system when evaluating their comments. A significant component of the evaluation process was: the generation of a report from the staff comments, presentation of the report directly to the system developer, and on-site visitation of individual staff and their care areas by the developer.



In terms of a CIS, nurses may have very different requirements and concerns than physicians, which frequently results in conflicting requests for software and GUI enhancements. In addition, different in-patient areas and specialties have very unique needs and possibly mutually exclusive CIS requirements. In-patient nursing areas primarily require software which will facilitate routine daily treatment, medication activities and scheduling of diagnostic appointments. The intensive care units, step down units, and emergency room also have very different requirements secondary to the physical layouts, patient care activities and nursing scope of practice. Case in point, hemodynamic alarms are critical in ICUs but not required on all in-patient words. Evaluation of end-users' comments should therefore be conducted in the following context: the nursing process, scope of practice, CIS capabilities, GUI and optimal physical interfaces.
Repository Posting Date:
26-Oct-2011
Date of Publication:
21-Jun-1993
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleEvaluation of clinical information systems for nursing practiceen_GB
dc.identifier.urihttp://hdl.handle.net/10755/156812-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Evaluation of clinical information systems for nursing practice</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">1993</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">June 21 - 22, 1993</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Beebe, Michael, DNS/DNSc/DSN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Michael Beebe Consulting</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Consultant</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">MBEEBE@UVVM.UVIC.CA</td></tr><tr><td colspan="2" class="item-abstract">The evaluation of software and graphical user inter-faces (GUI) intended for use by health care providers in clinical settings requires research methods yet to be adequately described in the literature. Conducting software and GUI evaluations for the clinical nursing environment requires education and skills taught in few educational institutions. If the introduction of a point-of-care clinical information system (CIS) is to be positive, the process of installation and enhancement of CIS software requires rigorous assessment/research methodologies. These methodologies involve complex interdependent interactions between end-users, developer, vendor, administrators, and evaluators to name a few.<br/><br/><br/><br/>For this study we evaluated one of the world's largest integrated CIS which is located in a 500 bed facility in the Northwest United States. The CIS has undergone continuous evolution and intense evaluation since going live in April 1992. During this time qualitative end-user surveys on software and GUI were longitudinal and cross-sectional with the responses falling into four broad categories: speed/ease of access to specific modules; access to the patient database; screen design; and visual prompts for health care providers. The suggestions themselves from all users seemed to fit into eight basic categories of: system management, system-wide functions, printing and batch processing, clinical notes, scrolling, patient-select screen design and medication/treatment sheets. Based on survey data the two most important factors on the depth and breadth of enhancements suggestions were end-user knowledge of information systems and nurses' clinical expertise areas.<br/><br/><br/><br/>Two different nurse-informatologists (neither of whom had been involved in the original design of the system) met with staff and administrators over the period of the evaluation process. Virtually all staff on all three shifts who use the CIS were visited by both evaluators. In general, staff were asked what they liked about the system, what they didn't like and what they would do to change the system to make it more functional for their needs. We found this open ended interview approach to be more useful than a paper questionnaire or closed-ended questioning. It was important to take into account staff computer literacy levels and familiarity with the system when evaluating their comments. A significant component of the evaluation process was: the generation of a report from the staff comments, presentation of the report directly to the system developer, and on-site visitation of individual staff and their care areas by the developer.<br/><br/><br/><br/>In terms of a CIS, nurses may have very different requirements and concerns than physicians, which frequently results in conflicting requests for software and GUI enhancements. In addition, different in-patient areas and specialties have very unique needs and possibly mutually exclusive CIS requirements. In-patient nursing areas primarily require software which will facilitate routine daily treatment, medication activities and scheduling of diagnostic appointments. The intensive care units, step down units, and emergency room also have very different requirements secondary to the physical layouts, patient care activities and nursing scope of practice. Case in point, hemodynamic alarms are critical in ICUs but not required on all in-patient words. Evaluation of end-users' comments should therefore be conducted in the following context: the nursing process, scope of practice, CIS capabilities, GUI and optimal physical interfaces.</td></tr></table>en_GB
dc.date.available2011-10-26T15:09:44Z-
dc.date.issued1993-06-21en_GB
dc.date.accessioned2011-10-26T15:09:44Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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