scholarly journals The Associations of Electronic Health Record Usability and User Age With Stress and Cognitive Failures Among Finnish Registered Nurses: Cross-Sectional Study (Preprint)

2020 ◽  
Author(s):  
Anu-Marja Kaihlanen ◽  
Kia Gluschkoff ◽  
Hannele Hyppönen ◽  
Johanna Kaipio ◽  
Sampsa Puttonen ◽  
...  

BACKGROUND Electronic health records (EHRs) are expected to provide many clinical and organizational benefits. Simultaneously, the end users may face unintended consequences, such as stress and increased cognitive workload, due to poor EHR usability. However, whether the effects of usability depend on end user characteristics, such as career stage or age, remains poorly understood. OBJECTIVE The objective of this study was to examine the associations of EHR usability and user age with stress related to information systems and cognitive failures among registered nurses. METHODS A cross-sectional survey design was employed in Finland in 2017. A total of 3383 registered nurses responded to the nationwide electronic survey. Multiple linear regression was used to examine the associations of EHR usability (eg, how easily information can be found and a patient’s care can be documented) and user age with stress related to information systems and cognitive failures. Interaction effects of EHR usability and age were also tested. Models were adjusted for gender and employment sector. RESULTS Poor EHR usability was associated with higher levels of stress related to information systems (β=.38; <i>P</i>&lt;.001). The strength of the association did not depend on user age. Poor EHR usability was also associated with higher levels of cognitive failures (β=.28; <i>P</i>&lt;.001). There was a significant interaction effect between age and EHR usability for cognitive failures (β=.04; <i>P</i>&lt;.001). Young nurses who found the EHR difficult to use reported the most cognitive failures. CONCLUSIONS Information system stress due to poor EHR usability afflicts younger and older nurses alike. However, younger nurses starting their careers may be more cognitively burdened if they find EHR systems difficult to use compared to older nurses. Adequate support in using the EHRs may be particularly important to young registered nurses, who have a lot to learn and adopt in their early years of practice.

10.2196/23623 ◽  
2020 ◽  
Vol 8 (11) ◽  
pp. e23623
Author(s):  
Anu-Marja Kaihlanen ◽  
Kia Gluschkoff ◽  
Hannele Hyppönen ◽  
Johanna Kaipio ◽  
Sampsa Puttonen ◽  
...  

Background Electronic health records (EHRs) are expected to provide many clinical and organizational benefits. Simultaneously, the end users may face unintended consequences, such as stress and increased cognitive workload, due to poor EHR usability. However, whether the effects of usability depend on end user characteristics, such as career stage or age, remains poorly understood. Objective The objective of this study was to examine the associations of EHR usability and user age with stress related to information systems and cognitive failures among registered nurses. Methods A cross-sectional survey design was employed in Finland in 2017. A total of 3383 registered nurses responded to the nationwide electronic survey. Multiple linear regression was used to examine the associations of EHR usability (eg, how easily information can be found and a patient’s care can be documented) and user age with stress related to information systems and cognitive failures. Interaction effects of EHR usability and age were also tested. Models were adjusted for gender and employment sector. Results Poor EHR usability was associated with higher levels of stress related to information systems (β=.38; P<.001). The strength of the association did not depend on user age. Poor EHR usability was also associated with higher levels of cognitive failures (β=.28; P<.001). There was a significant interaction effect between age and EHR usability for cognitive failures (β=.04; P<.001). Young nurses who found the EHR difficult to use reported the most cognitive failures. Conclusions Information system stress due to poor EHR usability afflicts younger and older nurses alike. However, younger nurses starting their careers may be more cognitively burdened if they find EHR systems difficult to use compared to older nurses. Adequate support in using the EHRs may be particularly important to young registered nurses, who have a lot to learn and adopt in their early years of practice.


2021 ◽  
Author(s):  
Tarja Heponiemi ◽  
Tuulikki Vehko ◽  
Gluschkoff Kia ◽  
Anu Kaihlanen ◽  
Kaija Saranto ◽  
...  

BACKGROUND High expectations have been set for the implementations of health information systems (HIS) in health care. However, nurses have been dissatisfied after HIS implementations. Especially poorly functioning electronic health records (EHRs) have been found to induce stress and cognitive work load. Moreover, need to learn new systems may require a lot of effort from nurses. Thus, EHR implementations may have an effect on the wellbeing of nurses. OBJECTIVE To examine the associations of EHR implementations and sufficiency of related training with perceived stress related to information systems (SRIS), time pressure and cognitive failures among registered nurses. Moreover, we examined whether employment sector would have an effect on these associations. METHODS Cross-sectional survey study among 3610 Finnish registered nurses in 2020. EHR Implementation was measured by assessing whether respondents’ work unit had implemented or will implement a new electronic health record (EHR) a) within past 6 months, b) within past 12 months, c) forthcoming within next 12 months and 4) no past or forthcoming implementations within 12 months. The associations were examined using analyses of covariance adjusted for age, gender and employment sector. RESULTS Highest levels of SRIS and time pressure were experienced among those who had experienced a EHR implementation within past 6 months. Lowest levels of SRIS, time pressure and cognitive failures were among those who did not have any past or forthcoming implementations within 12 months. Nurses who perceived that they had received sufficient implementation-related training experienced less SRIS, time pressure and cognitive failures. Recent implementations and insufficient training were especially strongly associated with high levels of SRIS in hospitals. CONCLUSIONS EHR implementations and insufficient training related to those implementations may endanger the wellbeing of nurses and even lead to errors. Thus, it would be utmost important that organizations would offer comprehensive training before, during and after implementations. Moreover, easy to use systems, allowing transition periods, re-engineering approach and user involvement might help nurses in the implementation process. Training and other improvements would be especially important at hospitals.


2009 ◽  
Vol 6 (1) ◽  
Author(s):  
Dag V. Haristad ◽  
Eivind A. Skille ◽  
Miranda Thurston

SummaryThis paper reports on the perspectives of elite athletes on anti-doping work in general and on the whereabouts system in particular, and uses a figurational perspective to explore the unintended consequences of the planned introduction of the whereabouts system. A cross-sectional survey of all the athletes in the Norwegian registered testing pool (n = 236, response rate = 80.8%) was carried out in 2006, using a structured questionnaire. Overall, 70.6% of the athletes agreed that doping was a problem in elite sport in general, but paradoxically only 17.5% agreed that doping was a problem in their own sport. However, more than four in ten (43%) of the athletes agreed that the whereabouts information system made a contribution to a “cleaner” sport. Some athletes thought the system was unfair. The whereabouts information system had, despite all good intentions, outcomes other than those planned and intended by the WADA. Thus, athletes’ views might fruitfully be integrated with other perspectives when anti-doping work is developed further.


2017 ◽  
Author(s):  
Francisco Lupiáñez-Villanueva ◽  
Dimitra Anastasiadou ◽  
Cristiano Codagnone ◽  
Roberto Nuño-Solinís ◽  
Maria Begona Garcia-Zapirain Soto

BACKGROUND Multimorbidity is becoming increasingly common and is a leading challenge currently faced by societies with aging populations. The presence of multimorbidity requires patients to coordinate, understand, and use the information obtained from different health care professionals, while simultaneously striving to distinguish the symptoms of different diseases and self-manage their sometimes conflicting health problems. Electronic health (eHealth) tools provide a means to disseminate health information and education for both patients and health professionals and hold promise for more efficient and cost-effective care processes. OBJECTIVE The aim of this study was to analyze the use of eHealth tools, taking into account the citizens’ sociodemographic and clinical characteristics, and above all, the presence of multimorbidity. METHODS Cross-sectional and exploratory research was conducted using online survey data from July 2011 to August 2011. Participants included a total of 14,000 citizens from 14 European countries aged 16 to 74 years, who had used an eHealth tool in the past 3 months. The variables studied were sociodemographic variables of the participants, the questionnaire items assessing the frequency of using eHealth tools, the degree of morbidity, and the eHealth adoption gradient. Chi-square tests were conducted to examine the relationship between the sociodemographic and clinical variables of participants and the group the participants were assigned to according to their frequency of eHealth use (eHealth user group). A one-way analysis of variance (ANOVA) allowed for assessing the differences in the eHealth adoption gradient average between different groups of individuals according to their morbidity level. A two-way between-groups ANOVA was performed to explore the effects of multimorbidity and age group on the eHealth adoption gradient. RESULTS According to the eHealth adoption gradient, most participants (68.15%, 9541/14,000) were labeled as rare users, with the majority of them (55.1%, 508/921) being in the age range of 25 to 54 years, with upper secondary education (50.3%, 464/921), currently employed (49.3%, 454/921), and living in medium-sized cities (40.7%, 375/921). Results of the one-way ANOVA showed that the number of health problems significantly affected the use of eHealth tools (F2,13996=11.584; P<.001). The two-way ANOVA demonstrated that there was a statistically significant interaction between the effects of age and number of health problems on the eHealth adoption gradient (F4,11991=7.936; P<.001). CONCLUSIONS The eHealth adoption gradient has proven to be a reliable way to measure different aspects of eHealth use. Multimorbidity is associated with a more intense use of eHealth, with younger Internet users using new technologies for health purposes more frequently than older groups with the same level of morbidity. These findings suggest the need to consider different strategies aimed at making eHealth tools more sensitive to the characteristics of older populations to reduce digital disadvantages.


2008 ◽  
Vol 29 (2) ◽  
pp. 99-106 ◽  
Author(s):  
Cori L. Ofstead ◽  
Sharon J. Tucker ◽  
Timothy J. Beebe ◽  
Gregory A. Poland

Objective.To evaluate the receipt of information and knowledge about influenza and vaccination, as well as influenza vaccination status and reasons for declining vaccination, among registered nurses.Design.Cross-sectional survey of registered nurses (RNs).Setting.A large tertiary medical center with a long-standing, multifaceted influenza vaccination program and relatively high vaccination rates among employees overall (76.5%).Participants.Randomly selected group of 990 RNs employed as inpatient staff nurses at the institution.Results.The survey was completed by 513 (51.8%) of 990 RNs. Most RNs (86.7%) had received an influenza vaccination in the past, and 331 (64.5%) intended to receive vaccination during the 2005-2006 influenza season. More than 90% of RNs acknowledged exposure to educational bulletins, and most had received information about influenza severity (383 [74.7%]), transmission (398 [77.6%]), vaccine safety (416 [81.1%]), and the time and location of free vaccination (460 [89.7%]). A majority (436 [85.0%]) felt they had received all the information they needed to make good decisions about vaccination. However, only 49 RNs (9.6%) gave correct answers to more than 85% of the knowledge questions on the survey. The reasons most frequently reported for declining vaccination were doubts about the risk of influenza and the need for vaccination, concerns about vaccine effectiveness and side effects, and dislike of injections.Conclusions.RNs exposed to a longstanding, multifaceted educational program had received information about influenza vaccination, but misconceptions were common and only 331 (64.5%) intended to receive vaccination. Strategies other than educational interventions are needed to increase influenza vaccination rates and thereby to ensure healthcare worker and patient safety.


2019 ◽  
pp. 67-76
Author(s):  
Carlos A Reyes Ortiz ◽  
Claudia Payan ◽  
Geraldine Altamar ◽  
Jose F Gomez Montes ◽  
Harold G Koenig

Objective: To identify the relationship between religiosity and self-rated health among older adults in Colombia. Methods: Data are drawn from the SABE (Salud, Bienestar y Envejecimiento) Colombia Study, a cross-sectional survey conducted in 2015 involving 18,871 community-dwelling adults aged 60 years and older living in urban and rural areas of Colombia. Religiosity was assessed by self-rated religiosity (how religious are you: not at all, somewhat or very). Self-rated health during previous 30 days was assessed as very good, good, fair, poor or very poor, analyzed as an ordinal variable(1-5) using weighted logistic regression, adjusting for confounders. Results: Those who were more religious were older, female, had lower socioeconomic status, and were more likely to be married. Multivariate analyses demonstrated that older adults who were more religious had better self-rated health (OR 0.92 95% CI 0.86- 0.99, p= 0.038); however, there was a significant interaction effect between gender and religiosity on self-rated health (p= 0.002), such that the relationship between religiosity and health was stronger in men (OR 0.86, 95% CI: 0.79-0.94, p= 0.001) but not significant in women. Conclusion: Older adults in Colombia who consider themselves more religious, especially men, are less likely to perceive their physical health as poor compared to those who are less religious.


2020 ◽  
Vol 29 (7) ◽  
pp. 419-425 ◽  
Author(s):  
Muhammad W Darawad ◽  
Mansour Mansour ◽  
Tahany Al-Niarat

Background: Newly qualified nurses (NQNs) face several challenges in their early years of practice. Being empowered and able to speak up against unsafe practice are two important pillars for practising nursing safely and competently. Little research has examined the potential correlation between those two dimensions in the context of NQNs in Jordan. Aims: To investigate the correlation between NQNs' perceived structural empowerment in their work setting and their willingness to challenge unsafe practice in some hypothetical clinical scenarios. Methods: A cross-sectional survey involved 233 NQNs, who completed a self-administered questionnaire between January and March 2016. Findings: Participants reported moderate levels of both perceived structural empowerment and willingness to speak up against unsafe practice. There was a statistically significant positive correlation between the total structural empowerment score and the mean score for speaking up against unsafe practice. Conclusion: The findings highlight the impact of peer, managerial and overall organisational support on enabling NQNs to become more empowered and assertive. Concrete, collaborative and organisation-wide efforts must be considered to foster greater empowerment of NQNs, but also revisiting work priorities to include supporting and advocating assertive communication skills among the more vulnerable of the newly qualified cohort.


2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Manuela Filipec ◽  
Gordana Brumini

Abstract Background Electronic health record can facilitate everyday clinical practice of physiotherapists. The aim of this study is to determine attitude of physiotherapists towards implementation of information technology in their work and the differences in attitude in relation to gender, age, level of education and type of health institutions. Methods This study is a cross-sectional survey of Croatian physiotherapists. The questionnaire ″Attitude of physiotherapists towards implementation of electronic health record included 12 items scored on a Likert-type scale from 1 to 5 and presented the award values as “Disagree”, “Neither agree nor disagree” and “Agree”. Croatian physiotherapists were (n = 267) recruited from 13 health care institutions. For analysis chi square test, t-test, one-way analysis of variance and as a post-hoc Tukey test were used. Results Explanatory factorial analysis confirmed two factors: Satisfaction in the work of physiotherapists using computers (SAT) and Necessity of computers in the work of physiotherapists (NEC). Most physiotherapists agree on (SAT) (47.9%) and on (NEC) (51.3%). Male physiotherapists were significantly more likely to disagree with statements related to SAT (p < 0.001) and NEC (p = 0.035) than female physiotherapists. Physiotherapists aged between 46 and 55 years were significantly more like to disagree on NEC in comparison to all the other groups of participants (p < 0.001). Physiotherapists with secondary school degree were significantly more like to disagree on NEC as compared with participants with bachelor’s degree (p = 0.009), as well as in comparison with physiotherapists with a university degree (p = 0.002). Most of the physiotherapists who are employed in Clinical hospitals and in the Speciality hospital agree with that statement (all p > 0.05). Conclusion The attitude of Croatian physiotherapists towards electronic health record differs according to the age, gender, level of education and type of health care institutions. This finding can facilitate implementation of electronic health record in physiotherapy. Trial registration Not applicable.


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