BUILDING CLINICAL INFORMATION SYSTEMS DEPENDENCE IN THE NURSING WORK ENVIRONMENT

2.50
Hdl Handle:
http://hdl.handle.net/10755/157275
Type:
Presentation
Title:
BUILDING CLINICAL INFORMATION SYSTEMS DEPENDENCE IN THE NURSING WORK ENVIRONMENT
Abstract:
BUILDING CLINICAL INFORMATION SYSTEMS DEPENDENCE IN THE NURSING WORK ENVIRONMENT
Conference Sponsor:Western Institute of Nursing
Conference Year:2010
Author:Garcia-Smith, Dianna, PhD, RN
P.I. Institution Name:University of Texas at Brownsville
Title:Assistant Professor
Contact Address:1517 Tesoro Avenue, Rancho Viejo, TX, 78575, USA
RESEARCH PURPOSE: The purpose of the study was to evaluate information quality and social influence on clinical information systems (CIS) dependency in the nurse work environment.
CONCEPTUAL PURPOSE/BACKGROUND: Even though most CIS today are technically sound, the number of successful applications is low. There is broad agreement that the major challenges to systems success often are more behavioral than technical. Theory driven information systems models and CIS studies exist, but no specific CIS evaluation framework has been proposed. In the mandatory work environment, assessing dependence on a CIS is more appropriate than the commonly used measure of frequency of use. CIS dependence has been defined as the extent to which the information system has integrated into each user's work routine. The Clinical Information System Success Model (CISSM) (developed by author) introduced this variable and supported information quality and social influence as predictors of clinician CIS dependence.
METHODS: This study is a predictive correlational design with content analysis of qualitative data collected. The participants were recruited from 234 medical, surgical and telemetry unit registered nurses from 45 units in 4 hospitals who had used the Cerner PowerChart Admission Health Profile (AHP) longer than 3 months. The hospitals were all from the same corporate hospital system but at different levels of CIS implementation. Participants' submitted an online questionnaire on their hospital work unit computers.
RESULTS: Construct validity and reliability of the 23-item online instrument were established. Multiple Regression analysis showed that Information Quality and Social Influence were direct determinants of CIS Use Dependency by the clinicians. However, analysis by levels of CIS integration revealed a significant difference in level of dependency by the clinicians. Qualitative content analysis of the "Your opinion is important! Please add any comments here" text responses revealed significantly more opinions and suggestions about the CIS information quality than the role of social influence. The two major themes identified were information quality and workflow issues. Workflow issues are part of the CISSM facilitating conditions that do not directly relate to CIS dependency processes. The RESULTS: supported that with increased integration of the CIS, there is an increase in Clinical Use Dependency and that an important part of this integration is attention to information quality. Workflow issues as they relate to the CIS appear to diminish over time.
IMPLICATIONS: The research findings contribute to our understanding of the nurse clinician's perceptions of how the clinical work environment affects the clinical success of CIS. The CISSM provides a framework to evaluate the overall success of a CIS on a formative as well as summative basis. As a result, intervention strategies specific to information quality, social factors or facilitating conditions can target issues more efficiently and effectively. Nursing informatics science will benefit by gaining additional information for improving ongoing evaluation of CIS clinical outcomes and as a result, help improve the quality of patient care.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleBUILDING CLINICAL INFORMATION SYSTEMS DEPENDENCE IN THE NURSING WORK ENVIRONMENTen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157275-
dc.description.abstract<table><tr><td colspan="2" class="item-title">BUILDING CLINICAL INFORMATION SYSTEMS DEPENDENCE IN THE NURSING WORK ENVIRONMENT</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2010</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Garcia-Smith, Dianna, PhD, RN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Texas at Brownsville</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Assistant Professor</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">1517 Tesoro Avenue, Rancho Viejo, TX, 78575, USA</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">dgsmith15@cox.net</td></tr><tr><td colspan="2" class="item-abstract">RESEARCH PURPOSE: The purpose of the study was to evaluate information quality and social influence on clinical information systems (CIS) dependency in the nurse work environment. <br/>CONCEPTUAL PURPOSE/BACKGROUND: Even though most CIS today are technically sound, the number of successful applications is low. There is broad agreement that the major challenges to systems success often are more behavioral than technical. Theory driven information systems models and CIS studies exist, but no specific CIS evaluation framework has been proposed. In the mandatory work environment, assessing dependence on a CIS is more appropriate than the commonly used measure of frequency of use. CIS dependence has been defined as the extent to which the information system has integrated into each user's work routine. The Clinical Information System Success Model (CISSM) (developed by author) introduced this variable and supported information quality and social influence as predictors of clinician CIS dependence. <br/>METHODS: This study is a predictive correlational design with content analysis of qualitative data collected. The participants were recruited from 234 medical, surgical and telemetry unit registered nurses from 45 units in 4 hospitals who had used the Cerner PowerChart Admission Health Profile (AHP) longer than 3 months. The hospitals were all from the same corporate hospital system but at different levels of CIS implementation. Participants' submitted an online questionnaire on their hospital work unit computers. <br/>RESULTS: Construct validity and reliability of the 23-item online instrument were established. Multiple Regression analysis showed that Information Quality and Social Influence were direct determinants of CIS Use Dependency by the clinicians. However, analysis by levels of CIS integration revealed a significant difference in level of dependency by the clinicians. Qualitative content analysis of the &quot;Your opinion is important! Please add any comments here&quot; text responses revealed significantly more opinions and suggestions about the CIS information quality than the role of social influence. The two major themes identified were information quality and workflow issues. Workflow issues are part of the CISSM facilitating conditions that do not directly relate to CIS dependency processes. The RESULTS: supported that with increased integration of the CIS, there is an increase in Clinical Use Dependency and that an important part of this integration is attention to information quality. Workflow issues as they relate to the CIS appear to diminish over time. <br/>IMPLICATIONS: The research findings contribute to our understanding of the nurse clinician's perceptions of how the clinical work environment affects the clinical success of CIS. The CISSM provides a framework to evaluate the overall success of a CIS on a formative as well as summative basis. As a result, intervention strategies specific to information quality, social factors or facilitating conditions can target issues more efficiently and effectively. Nursing informatics science will benefit by gaining additional information for improving ongoing evaluation of CIS clinical outcomes and as a result, help improve the quality of patient care. <br/></td></tr></table>en_GB
dc.date.available2011-10-26T19:43:29Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T19:43:29Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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