Developing Theoretical Underpinnings for Nursing Workaround Research Using a Mixed Method Approach

2021 ◽  
Author(s):  
Jennifer Browne ◽  
Carrie Jo Braden
Keyword(s):  
Information Technology ◽  
Health Information Technology ◽  
Health Information ◽  
Acute Care ◽  
Medication Administration ◽  
Mixed Method Approach ◽  
Level Model ◽  
Multi Level ◽  
Method Approach ◽  
Associated Variables

The use of health information technology (HIT) in acute care had an unexpected impact on nursing workflow. It often took a nurse extra steps or extra time to complete a process once documentation and medication administration was automated. In response to HIT problems, nurses developed workarounds. Research on workarounds has been hindered by a lack of variable definitions and research models. This paper presents results of a mixed methods study that proposes definitions for workarounds, associated variables and a multi-level model.

Best Practices for Implementing Electronic Health Records and Information Systems

2010 ◽  
pp. 120-138 ◽  
Author(s):  
Beste Kucukyazici ◽  
Karim Keshavjee ◽  
John Bosomworth ◽  
John Copen ◽  
James Lai
Keyword(s):  
Information Technology ◽  
Information Systems ◽  
Electronic Health Records ◽  
Health Information Technology ◽  
Health Information ◽  
Technology Implementation ◽  
Healthcare Organizations ◽  
Implementation Framework ◽  
Multi Level ◽  
Insight Into

This chapter introduces a multi-level, multi-dimensional meta-framework for successful implementations of EHR in healthcare organizations. Existing implementation frameworks do not explain many features experienced and reported by implementers and have not helped to make health information technology implementation any more successful. To close this gap, we have developed an EHR implementation framework that integrates multiple conceptual frameworks in an overarching, yet pragmatic meta-framework to explain factors which lead to successful EHR implementation, in order to provide more quantitative insight into EHR implementations. Our meta-framework captures the dynamic nature of an EHR implementation through their function, interactivity with other factors and phases, and iterative nature.

Best Practices for Implementing Electronic Health Records and Information Systems

2011 ◽  
pp. 994-1013
Author(s):  
Beste Kucukyazici ◽  
Karim Keshavjee ◽  
John Bosomworth ◽  
John Copen ◽  
James Lai
Keyword(s):  
Information Technology ◽  
Information Systems ◽  
Electronic Health Records ◽  
Health Information Technology ◽  
Health Information ◽  
Technology Implementation ◽  
Healthcare Organizations ◽  
Implementation Framework ◽  
Multi Level ◽  
Insight Into

This chapter introduces a multi-level, multi-dimensional meta-framework for successful implementations of EHR in healthcare organizations. Existing implementation frameworks do not explain many features experienced and reported by implementers and have not helped to make health information technology implementation any more successful. To close this gap, we have developed an EHR implementation framework that integrates multiple conceptual frameworks in an overarching, yet pragmatic meta-framework to explain factors which lead to successful EHR implementation, in order to provide more quantitative insight into EHR implementations. Our meta-framework captures the dynamic nature of an EHR implementation through their function, interactivity with other factors and phases, and iterative nature.

scholarly journals A systematic review of the impact of health information technology on nurses’ time

2020 ◽  
Vol 27 (5) ◽  
pp. 798-807 ◽  
Author(s):  
Esther C Moore ◽  
Clare L Tolley ◽  
David W Bates ◽  
Sarah P Slight
Keyword(s):  
Systematic Review ◽  
Information Technology ◽  
Health Information Technology ◽  
Health Information ◽  
Care Home ◽  
Medication Administration ◽  
Direct Patient Care ◽  
Nursing Time ◽  
Weighted Averages ◽  
The Impact

Abstract Objective Nursing time represents one of the highest costs for most health services. We conducted a systematic review of the literature on the impact of health information technology on nurses’ time. Materials and Methods We followed PRISMA guidelines and searched 6 large databases for relevant articles published between Jan 2004 and December 2019. Two authors reviewed the titles, abstracts, and full texts. We included articles that included a comparison group in the design, measured the time taken to carry out documentation or medication administration, documented the quantitative estimates of time differences between the 2, had nurses as subjects, and was conducted in either a care home, hospital, or community clinic. Results We identified a total of 1647 articles, of which 33 met our inclusion criteria. Twenty-one studies reported the impact of 12 different health information technology (HIT) implementations on nurses’ documentation time. Weighted averages were calculated for studies that implemented barcode medication administration (BCMA) and 2 weighted averages for those that implemented EHRs, as these studies used different sampling units; both showed an increase in the time spent in documentation (+22% and +46%). However, the time spent carrying out medication administration following BCMA implementation fell by 33% (P < .05). HIT also caused a redistribution of nurses’ time which, in some cases, was spent in more “value-adding” activities, such as delivering direct patient care as well as inter-professional communication. Discussion and Conclusions Most of the HIT systems increased nursing documentation time, although time fell for medication administration following BCMA. Many HIT systems also resulted in nurses spending more time in direct care and “value-adding” activities.

Recommendations for health information technology implementation in rural hospitals

2016 ◽  
Vol 29 (4) ◽  
pp. 454-474 ◽  
Author(s):  
Yuan-Han Huang ◽  
Anand K. Gramopadhye
Keyword(s):  
Information Technology ◽  
Health Information Technology ◽  
Health Information ◽  
Rural Areas ◽  
Continuous Process ◽  
Medication Administration ◽  
Rural Hospitals ◽  
Scanning System ◽  
Content Type ◽  
Healthcare Facilities

Purpose – The purpose of this paper is to investigate violations against work standards associated with using a new health information technology (HIT) system. Relevant recommendations for implementing HIT in rural hospitals are provided and discussed to achieve meaningful use. Design/methodology/approach – An observational study is conducted to map medication administration process while using a HIT system in a rural hospital. Follow-up focus groups are held to determine and verify potential adverse factors related to using the HIT system while passing drugs to patients. Findings – A detailed task analysis demonstrated several violations, such as only relying on the barcode scanning system to match up with patient and drugs could potentially result in the medical staff forgetting to provide drug information verbally before administering drugs. There was also a lack of regulated and clear work procedure in using the new HIT system. In addition, the computer system controls and displays could not be adjusted so as to satisfy the users’ expectations. Nurses prepared medications and documentation in an environment that was prone to interruptions. Originality/value – Recommendations for implementing a HIT system in rural healthcare facilities can be categorized into five areas: people, tasks, tools, environment, and organization. Detailed remedial measures are provided for achieving continuous process improvements at resource-limited healthcare facilities in rural areas.

Health Information Technology Adoption in U.S. Acute Care Hospitals

2013 ◽  
Vol 37 (2) ◽  
Author(s):  
Ning Jackie Zhang ◽  
Binyam Seblega ◽  
Thomas Wan ◽  
Lynn Unruh ◽  
Abiy Agiro ◽  
...  
Keyword(s):  
Information Technology ◽  
Technology Adoption ◽  
Health Information Technology ◽  
Health Information ◽  
Acute Care ◽  
Acute Care Hospitals ◽  
Information Technology Adoption
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