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Nursing Nursing Informati tion Syste tem A relevant t substi titu tute te of th the paper record M.B. Michel-Verkerke Saxion University of Applied Sciences, Enschede, The Netherlands MIE 2011 Oslo, August 31 Nurse Donna Taylor uses a

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Kom verder. Saxion.

Nursing Nursing Informati tion Syste tem

A relevant t substi titu tute te of th the paper record

Nurse Donna Taylor uses a computer on wheels (COW) in the Emergency Department of Baptist Memorial Hospital DeSoto to enter patients' chart information. Photo by Thomas Busler/The Commercial Appeal http://www.commercialappeal.com/photos/2009/mar/05/105455/ This photograph is retrieved from the Internet. Neither the nurse, nor the hospital are involved in my research.

M.B. Michel-Verkerke Saxion University of Applied Sciences, Enschede, The Netherlands MIE 2011 Oslo, August 31

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Agend Agenda a

Th Theory eory: Relev

Relevan ance ce an and accepta tance

Meth thods: Questi

tionnaire an and inte terviews

Case: Case:

Nursing Nursing Informati tion Syste tem

Results ts: Use

Use an and use useful fulne ness ss

Conclusion Conclusion: N

Nurs rses es pref prefer er N NIS IS

Dia 2 - MIE 2011 - 31 August 2011 - M.B. Michel-Verkerke

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Th Theory eory

  • Jo

Job relev relevan ance ce, outp tput t quality ty an and resu result lt demonstr trability ty contr tribute te to to perceiv perceived ed use useful fulne ness ss in in TA TAM3 ( M3 (Venkate tesh & & Bala Bala, , 2008) 2008)

Dia 3 - MIE 2011 - 31 August 2011 - M.B. Michel-Verkerke

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IS ISSM ( M (De DeLone & McLean & McLean, 2003) , 2003)

  • Relev

Relevan ance ce an and use useful fulne ness ss are aspects ts of Informati tion Quality ty

Dia 4 - MIE 2011 - 31 August 2011 - M.B. Michel-Verkerke

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USE E IT

USE E IT model User Do Domain Informati tion Technology Do Domain Product Relevance Requirements Process Resistance Resources

Micro-relevance: degree to which IT-use helps to solve the here-and-

now problem of the user in his

working process (Spil et al, 2006)

Dia 5 - MIE 2011 - 31 August 2011 - M.B. Michel-Verkerke

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Research questi tion:

  • Wh

What at is micro-relevant t to to th the users

  • f th

the Nursing Nursing Informati tion Syste tems? an and

  • Do

Does th the NIS meet t th the nurses’ expecta tati tions in th these aspects ts?

Dia 6 - MIE 2011 - 31 August 2011 - M.B. Michel-Verkerke

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Case Case

  • Ev

Evaluati tion of NIS afte ter implementa tati tion to to replace replace paper paper nur nursi sing ng record in record in six six wa wards in in te teaching hospita tal

Dia 7 - MIE 2011 - 31 August 2011 - M.B. Michel-Verkerke

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Meth thods: :

  • Inte

terviews:

– USE E IT-model: – 6 n 6 nurs rses es no not usi using ng N NIS IS + + 6 6 use users

  • Questi

tionnaire:

– Sta tate tements ts : five-point- t-scale – Few Few open

  • pen questi

tions – Res Respon ponse w e was as 48% (93 of 48% (93 of all 195 all 195 use users) )

Dia 8 - MIE 2011 - 31 August 2011 - M.B. Michel-Verkerke

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Inte terview results ts

  • Pr

Provid viding ing go good care, care, so so pati tient feels feels we well, is most t importa tant t

  • Nurses

Nurses pref prefer er to to use use N NIS IS, ,

  • NIS

NIS is is orderly

  • rderly,

, readable readable, m , more

  • re

informati tion, bette tter acces access

  • Pa

Paper er fo forms ms cau cause se extr tra wo work

  • Tim

Time is e is alw always ays short t

Dia 9 - MIE 2011 - 31 August 2011 - M.B. Michel-Verkerke

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NIS NIS is is use used daily daily or

  • r we

weekly fo for essenti tial functi tions

Copy history from previous record 76% Copy data from history to care plan 85% Make nursing plan 79% Report on category 63% Report on multi-disciplinary problem or nursing plan 51% Make multi-disciplinary problem 29% Use nursing plan example 10%

Dia 10 - MIE 2011 - 31 August 2011 - M.B. Michel-Verkerke

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Support t of care prov providin iding (M) (M)

Quick first impression of patient 3.78 Quick complete view of patient 3.22 Quick insight in necessary care 3.65 Quick overview of provided care 3.49 Quick insight in goals 3.06 Better support of multi-disciplinary collaboration 3.13

Dia 11 - MIE 2011 - 31 August 2011 - M.B. Michel-Verkerke

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Usefulness Usefulness (M) (M)

Perform tasks better 2.94 Spend more time on direct care 2.43 Useful and usable 3.70 Do not want to do without anymore 3.37 Advantages compensate amply for disadvantages 3.51 NIS has advantages compared to paper record 3.64

Dia 12 - MIE 2011 - 31 August 2011 - M.B. Michel-Verkerke

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Informati tion quality ty (M) (M)

Reports are kept up-to-date 4.01 No patient data in wrong record 2.68 Quality of recording raises 3.59 Oral and written reports are not contradictory 3.89 Precisely the information I need 3.21 Contains all information I need 3.26 Access anytime 3.40 Can enter all information I want 3.54

Dia 13 - MIE 2011 - 31 August 2011 - M.B. Michel-Verkerke

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Op Open en questi tions

Advanta tages Di Disadvanta tages Readability 45% Technical problems 50% Not everybody uses NIS accurately 11% No access for patient 15%

Dia 14 - MIE 2011 - 31 August 2011 - M.B. Michel-Verkerke

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Di Discussion: : con con’s ’s

  • NIS

NIS does es no not save ti time, except except fo for copyin copying data ta

  • Tech

Technical ical problem problems with th COW COW’s

  • Main

Mainly ly essenti tial functi tions are are use used

  • Ris

Risk of k of errors errors, , becau because of

  • f

complexity ty of

  • f so

some me functi tions

Dia 15 - MIE 2011 - 31 August 2011 - M.B. Michel-Verkerke

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Di Discussion: pro’s : pro’s

  • Nurses

Nurses pref prefer er N NIS IS

  • NIS

NIS sup supplies lies complete te, leg legible ible pati tient data ta

  • Access

Access an anyw ywhere ere, , anyti time

Dia 16 - MIE 2011 - 31 August 2011 - M.B. Michel-Verkerke

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Conclusions Conclusions

  • NIS

NIS is is go good substi titu tute te fo for paper paper record record

  • Informati

tion is more micro-relevant t th than ti time (probably probably) )

  • Comb

Combining ining qualita tati tive an and quanta tati tive meth thods in in so socio cio- te technical approach approach create tes added added va value ue

Dia 17 - MIE 2011 - 31 August 2011 - M.B. Michel-Verkerke

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Micro- Micro-relev relevan ance ce of

  • f a C

a COW: W:

Dia 18 - MIE 2011 - 31 August 2011 - M.B. Michel-Verkerke Nurse Donna Taylor uses a computer on wheels (COW) in the Emergency Department

  • f Baptist Memorial Hospital DeSoto to enter

patients' chart information. Photo by Thomas Busler/The Commercial Appeal http://www.commercialappeal.com/photos/ 2009/mar/05/105455/ This photograph is retrieved from the

  • Internet. Neither the nurse, nor the hospital

are involved in my research.

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Questi tions? ?

m. m.b.mi miche hel@utw twente te.nl

  • MIE 2011 - 31 August 2011 - M.B. Michel-Verkerke