Introduction of Wireless, Pen-Based Computing Among Visiting Nurses in the Inner City: A Qualitative Study

Abstract

The purpose of this qualitative study is to understand how a sample of visiting nurses experienced the practice of home health nursing in the inner city and how they perceived the anticipated introduction of wireless, pen-based computing into their practice. Focus groups were held with visiting nurses 1 week before the introduction of the wireless, pen-based computers. The data were analyzed using Strauss and Corbin's (1990) method for concept development. The following central concepts emerged from the focus groups with visiting nurses: "Missing contact in the field," "Consumption of time writing on forms," "Using the computer to help with the practice of home health nursing," and "Home nursing is a lifeline." These concepts, based on the commentaries by visiting nurses, help one to understand the problems encountered by visiting nurses in the delivery of home health care, identify ways to incorporate evolving technologies to enhance nursing practice, and consider approaches to computer skill acquisition.

‘Rage against the machine?’: nurses’ and midwives’ experiences of using Computerized Patient Information Systems for clinical information

“…Considering that ‘Automated information systems have been part of the health care environment for nearly 30 years (Manning & McConnell, 1997, p. 141), it is surprising that few studies have explored clinicians’ perspectives of using CPIS (Timpka & Johansson, 1994; Karlsson et al. , 1997; Valenta & Wigger, 1997; Wilson & Fulmer, 1997). There are numerous studies of ‘nurses attitudes to’ various aspects of CPIS (see e.g.…”

Development and Testing of an Evaluation Scale of Personal Digital Assistants

“…In addition, nurse participants wrote negative comments about device features (data entry, response time, system downtime, and concerns about theft and loss), similar to comments from previous reports. 10,11,19,20 However, the clustering of these negative items in one construct may pose a response bias for the ESPDA, which could be eliminated by changing the language or wording of some items. [34][35][36] Because user concerns about PDA features such as screen size, device theft, and data transmission are not unique to this study, these issues deserve further research and improvement.…”

“…Early qualitative studies found that although home health nurses welcomed using penbased wireless computers in their daily practice, they were concerned about issues of hardware maintenance, technical support, and device theft or loss. 19,20 Penbased computers improved the quality of documentation for home health nurses compared with manual records by providing immediate access to an easily readable record and decreasing calculation errors, but the time spent on patient care and documentation did not change significantly. 21 In addition, PDAs were used to establish a database for an intravenous resource nurse service, but its use was limited by slow response time after entering large amounts of data and by the attention needed to maintain the hardware (eg, keeping the battery charged, avoiding accidentally dropping the PDA).…”

A primary care physician perspective survey on the limited use of handwriting and pen computing in the electronic medical record

“…It was also noted in Wilson's US study of visiting nurses. 31 In that study they believed that a totally structured templated note was incomplete. Richards likewise indicated that a template telephone message lacked the personalisation and detail required to prevent future misunderstandings.…”