Organisational influences on nurses’ use of clinical decision support systems

Randell, Rebecca; Dowding, Dawn

doi:10.1016/j.ijmedinf.2010.02.003

Cited by 42 publications

(54 citation statements)

References 28 publications

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“…However the findings from this study clearly underscore that, to successfully implement and sustain e-health applications in daily practice, the users must recognize that it is beneficial in their daily work and for the patients [52,53]. Understanding a tool's utility affects the motivation both to use the system and to encourage the patient to participate [54].…”

Section: Observabilitymentioning

confidence: 85%

Nurses’ experiences of using an interactive tailored patient assessment tool one year past implementation

Børøsund

Ruland

Moore

et al. 2014

International Journal of Medical Informatics

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Please cite this article in press as: E. Børøsund, et al., Nurses' experiences of using an interactive tailored patient assessment tool one year past implementation, Int. J. No. of Pages 12 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 x x x ( 2 0 1 3 ) xxx-xxx 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 Nurses' experiences of using an interactive tailored patient assessment tool one year past implementation Objective: To explore nurses' experiences of the benefits of and barriers to using an ITPA called Choice, in cancer care one year after its implementation. ARTICLE IN PRESSMethods: This investigation is a part of a larger study examining the use of Choice in cancer care. Four focus group interviews were conducted with 20 nurses experienced in using the Choice application. The data were analyzed using qualitative content analysis.Results: Three themes and nine sub-themes emerged: (1) "Choice as facilitator for shared understanding and engagement in patients' own care," with three sub-themes: preparing both patient and nurse for communication, shared engagement in care planning, and giving the patients a voice; (2) "enhancing the patients' strengths," with two sub-themes: releasing patient's internal strengths and confirming "normalcy" for the patient; and (3) "new challenges for the nurse," with four sub-themes: organizational challenges, interactions with technology, a need for training in communication skills, and new ethical challenges. Conclusions: Findings suggest that, from nurses' perspectives, integration of ITPAs suchas Choice in clinical practice offers many benefits that can contribute to patient-centered care. However, to reap these benefits, use of such tools must receive equal priority as other routines, and require sufficient time, space and competence. Choice also challenged nurses' professional roles and created dilemmas such as nurses' ambivalence regarding patients' levels of disclosure of sensitive issues and the nurses' ability to respond to

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Section: Observabilitymentioning

confidence: 85%

Nurses’ experiences of using an interactive tailored patient assessment tool one year past implementation

Børøsund

Ruland

Moore

et al. 2014

International Journal of Medical Informatics

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“…The impact of a CDSS on nurses' decision making must be explored in future research [59]. Studies have shown that implementing an EHR does not unilaterally indicate that documentation comprehensiveness will increase [38,60].…”

Section: Discussionmentioning

confidence: 99%

Effects of a computerized decision support system on care planning for pressure ulcers and malnutrition in nursing homes: An intervention study

Fossum

Ehnfors

Svensson

et al. 2013

International Journal of Medical Informatics

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Background: Nursing documentation is essential for facilitating the flow of information to guarantee continuity, quality and safety in care. High-quality nursing documentation is frequently lacking; the implementation of computerized decision support systems is expected to improve clinical practice and nursing documentation. Aim:The present study aimed at investigate the effects of a computerized decision support system and an educational program as intervention strategies for improved nursing documentation practice on pressure ulcers and malnutrition in nursing homes.Design, setting and participants: An intervention study with two intervention groups and one control group was used. Fifteen nursing homes in southern Norway were included. A convenience sample of electronic healthcare records from 46 units was included. Inclusion criteria were records with presence of pressure ulcers and/or malnutrition. The residents were assessed before and after an intervention of a computerized decision support system in the electronic healthcare records. Data were collected through a review of 150 records before (2007) Methods:The nurses in intervention group 1 were offered educational sessions and were trained to use the computerized decision support system, which they used for eight months in 2008 and 2009. The nurses in intervention group 2 were offered the same educational program but did not use the computerized decision support system. The nurses in the control group were not subject to any intervention. The resident records were examined for the completeness and comprehensiveness of the documentation of pressure ulcers and malnutrition with three data collection forms and the data were analyzed with non-parametric statistics. Results:The implementation of the computerized decision support system and the educational program resulted in a more complete and comprehensive documentation of pressure ulcer-and malnutrition-related nursing assessments and nursing interventions. Conclusion:This study provides evidence that the computerized decision support system and an educational program as implementation strategies had a positive influence on nursing documentation practice.Key words: decision support system, documentation, intervention studies, malnutrition, nursing audit, pressure ulcer. Highlights A computerized decision support system and an educational program were implemented. The computerized decision support system provided evidence-based interventions. The implementation resulted in a more complete and comprehensive documentation. The total number of documented nursing problems was relatively low.

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“…There are many factors in health care organization that can have an impact on information systems such as organizational culture that is one of the most important factors in the success of technology implementation (Randell et al, 2010). Flexible organizational structure and leadership behaviors and providing an environment in which innovation in organizations is appreciated facilitate moving towards technologies (Vaccaro et al, 2012).…”

Section: Health Care Organizationmentioning

confidence: 99%

Cancer Care Management through a Mobile Phone Health Approach: Key Considerations

Mohammadzadeh

Safdari²,

Rahimi³

2013

Asian Pacific Journal of Cancer Prevention

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Organisational influences on nurses’ use of clinical decision support systems

Abstract: ObjectiveNurses are increasingly using computerised decision support systems (CDSS) to support their practice. Previous studies have highlighted the importance organisational factors have on the successful implementation of new technologies in healthcare.

Cited by 42 publications

References 28 publications

Nurses’ experiences of using an interactive tailored patient assessment tool one year past implementation

Nurses’ experiences of using an interactive tailored patient assessment tool one year past implementation

Effects of a computerized decision support system on care planning for pressure ulcers and malnutrition in nursing homes: An intervention study

Cancer Care Management through a Mobile Phone Health Approach: Key Considerations

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