11/30/2022 0 Comments Nvivo 10 has stopped workingThe structure for the first five themes was derived from previous work that delineated confirmed nurses’ expectations ranging from personal-level to organizational-level. Themes reflected a general description of the nurse participants’ experience with EHRs and BCMA. The researchers generated common themes by synthesizing the meaning units. Three researchers (IZ, JGS, and PY) read the transcripts independently and located relevant statements in the transcripts that expressed units of meaning. Although studies exist regarding clinicians’ adaptation to HIT, there is insufficient qualitative evidence regarding facilitators, hindrances, and a longitudinal timeline of adaptation, especially among clinical nurses. Positive computer attitudes are a significant predictor of fast adaptation. The authors explained that other EHR functionalities may have greater precedence over time to influence acceptance. In the United States, ICU nurses perceived the EHR as useful (through access to up-to-date information) at 3 months, but perceived that usefulness was not as relevant for acceptance at 12 months. A study conducted in Taiwan reported that nurses needed 3 months to understand the functionalities and benefits of an EHR. For nurses, the timeline of adaptation for new HIT varies. In contrast, US nurses working on inpatient units within an academic medical center reported less positive attitudes toward the EHR 18 months after implementation compared to preimplementation and 6 months postimplementation. Intensive care unit (ICU) nurses completed two cross-sectional survey questionnaires at 3 months and 12 months after EHR implementation and reported greater acceptance of the EHR at 12 months compared to 3 months. Longitudinal perceptions of EHRs have also been studied in nurses. In primary care, even two years after EHR implementation, the EHR learning curve and computer knowledge remained challenging for interprofessional staff. In a similarly-designed study, ophthalmologists did not report a significant change in overall job satisfaction over time (3, 7, 13, and 24 months post-EHR implementation), but they expressed concern about the EHR’s effect on interactions with patients and their ability to create quality documentation. Physicians reported that the EHR created additional work and their satisfaction dropped. Safety perceptions dropped during the first six months, but then began to rise. For example, a two-year prospective, longitudinal survey of attending physicians in three clinical areas experienced the change from a homegrown EHR to a vendor EHR. Researchers have studied provider perceptions of HIT over time, describing the mixed (both positive and negative) effects of HIT. A socio-technical model offers insights for studying HIT in complex adaptive health care systems through eight dimensions, including: (1) hardware and software computing infrastructure (2) clinical content (3) human-computer interface (4) people (5) workflow and communication (6) internal organizational policies, procedures, and culture (7) external rules, regulations, and pressures and (8) system measurement and monitoring. Longitudinal Qualitative Studies About Clinicians’ Perceptions of HITĪ myriad of individual and organizational factors influence HIT, contributing to its complexity and multi-dimensional nature. A few unintended adverse consequences of EHRs are incomplete information, usability issues leading to frustrating user experiences, and patient privacy breaches. HIT problems are noteworthy because they may result in delayed care, altered clinical decision-making, and modified care processes, which affect patient outcomes. While providers and patients appreciate the positive benefits of HIT through improved care, there are also problems with HIT. An EHR is a repository of patient data that is stored and exchanged securely among multiple authorized users to support quality integrated health care. In the United States, by 2015 96% of all hospitals had adopted a certified electronic health record (EHR). Health information technology (HIT or Health IT) is a broad concept that includes a variety of technologies, including computer equipment, system software, and infrastructure that records, stores, protects, and retrieves clinical, administrative, or financial information.
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