Adoption of Hospital Information System Among Nurses: a Technology Acceptance Model Approach

Exploring the Usage Effectiveness of a Nursing Charge System

The nursing charge system for inpatient accounting has been utilized in healthcare institutions for years. However, the level of its effectiveness in meeting the needs of nursing services, including further development, has not been systematically evaluated. A cross-sectional study based in Delone and McLean's information system success model was applied to explore the level of effective nursing charge system usage across the five dimensions of system quality, information quality, service quality, user satisfaction, and net benefits. We conducted a survey of the inpatient units of a medical center in Taiwan from June 23, 2021, to July 23, 2021. A total of 214 valid questionnaires were collected. Using a 5-point Likert scale, the dimension with the highest score was information quality (3.71), followed by service quality (3.37), user satisfaction (3.36), net benefits (3.31), and system quality (3.23). Older nurses (r = -0.176) and those with more clinical experience (r = -0.151) viewed the nursing charge system as having less information quality. The comfort level with using the computer was positively associated with system quality (r = 0.396), information quality (r = 0.378), service quality (r = 0.275), user satisfaction (r = 0.417), and net benefits (r = 0.355). The opinions of nurses are vital. User feedback and advice should be investigated regularly to achieve system optimization.

Development and Application Evaluation of a Nursing Simulation Teaching Information System Based on Hospital Information Systems

BACKGROUND

The extensive application of hospital information systems in the current information-driven era suggests that nursing education should focus on information education.

METHODS

The newly developed hospital information system was used and evaluated by 544 students to explore the feasibility and necessity of such applications for teaching.

RESULTS

Overall, 97.1% of the students expressed satisfaction, and 96.0% supported simulated information education for nursing. The usability was good, with the system receiving a usability score of 72.625 ± 13.0907. The junior students had a higher score than the sophomores regarding system availability, and the difference was statistically significant.

CONCLUSIONS

Students generally had a high degree of satisfaction with the simulated information nursing education system and highly approved of the teaching method. However, the system needs to be upgraded.

Determinants predicting the electronic medical record adoption in healthcare: A SEM-Artificial Neural Network approach

An Electronic Medical Record (EMR) has the capability of promoting knowledge and awareness regarding healthcare in both healthcare providers and patients to enhance interconnectivity within various government bodies, and quality healthcare services. This study aims at investigating aspects that predict and explain an EMR system adoption in the healthcare system in the UAE through an integrated approach of the Unified Theory of Acceptance and Use of Technology (UTAUT), and Technology Acceptance Model (TAM) using various external factors. The collection of data was through a cross-section design and survey questionnaires as the tool for data collection among 259 participants from 15 healthcare facilities in Dubai. The study further utilised the Artificial Neural Networks (ANN) algorithm and the Partial Least Squares Structural Equation Modeling (PLS-SEM) in the analysis of the data collected. The study’s data proved that the intention of using an EMR system was the most influential and predictor of the actual use of the system. It was also found that TAM construct was directly influenced by anxiety, innovativeness, self-efficacy, and trust. The behavioural intention of an individual regarding EMR was also proved to positively influence the use of an EMR system. This study proves to be useful practically by providing healthcare decision-makers with a guide on factors to consider and what to avoid when implementing strategies and policies.

Identification and Classification of Usability Problems in a Nursing Information System: A Heuristic Evaluation

Nursing information system is a system that nurses are required to use in order to perform their daily activities. Poor user interface design of nursing information system can cause problems in nurses' interaction with the system. This research aimed to evaluate the usability of nursing information system. During this study, five evaluators examined the nursing information system with the heuristic evaluation method and by using the checklist of Nielsen usability principles. Then, the identified problems were categorized into 10 Nielsen usability principles, and the severity of the problems was determined. They also attributed each problem to one of usability attributes. A total of 104 unique problems were identified. Most of the problems were related to the principle of "consistency and standards." More than a third of the identified problems were classed as major and catastrophe, with the highest severity in the average problems of "help and documentation" and "error prevention." Most of the identified problems were attributed to effectiveness and satisfaction. Because a significant number of identified usability problems in nursing information system were major and catastrophe and were attributed to effectiveness and satisfaction, being able to remedy the problems could improve nurses' interaction with the system user interface and increase satisfaction and effectiveness of nurses.

Factors associated with nurses' user resistance to change of electronic health record systems

Background

Electronic health record (EHR) systems often face user resistance in hospitals, which results in a failure to acquire their full benefits. To implement the EHR successfully, it is crucial to reduce nurses’ resistance to use the system. This study aimed to investigate the factors associated with nurses’ resistance to use the EHR system.

Methods

A descriptive correlational study was conducted with nurses working at four university hospitals in Korea using self-administered questionnaires to measure user resistance behavior, resistance to change, perceived usefulness, perceived ease of use, perceived value, colleagues’ opinions, self-efficacy for change, and organizational support for change. Path analysis was performed to examine direct and indirect association with user resistance behavior.

Results

A total of 223 nurses completed the questionnaires. All seven factors were found to be significantly associated with user resistance, either directly or indirectly. The total effect on user resistance behavior was highest in resistance to change (0.65), followed by perceived usefulness (− 0.33); both had direct but no indirect effects. Conversely, self-efficacy for change (− 0.25), perceived value (− 0.21), colleagues’ opinions (− 0.16), perceived ease of use (− 0.16), and organizational support for change (− 0.05) had indirect but no direct effects.

Conclusions

The study examined the factors associated with nurses’ user resistance behavior after the implementation of a new EHR system. These findings could help hospitals develop better EHR implementation strategies to reduce user resistance behavior among the nursing staff.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12911-021-01581-z.

Usability evaluation of a nursing information system by applying cognitive walkthrough method

BACKGROUND AND OBJECTIVE

The user interface usability of the nursing information system (NIS) should be such that the nurses can learn and interact with it easily and quickly. Therefore, it is necessary to identify and solve the usability problems of these systems. The present study aimed to evaluate the usability of a NIS using the cognitive walkthrough (CW) evaluation method.

METHODS

Based on five selected scenarios, five evaluators evaluated the NIS in Shafa Hospital Information System. After identifying the problems, the evaluators assigned each problem to one of the usability attributes. The severity of each identified problem was determined by the evaluators and five real users of the system.

RESULTS

In total, 24 unique problems were identified. The average severity of the problems was determined by the evaluators (2.77) and the actual users (2.82) in the "major problem" category. The highest number of problems were assigned to the scenarios 3 and 2 with 15 and 14 problems, respectively. The highest average severity in terms of evaluations and actual users was related to the scenario 5 (3.06 and 2.94, respectively), which was in the "major problem" category. The highest number of problems were associated with learnability (8 problems) and efficiency (6 problems).

CONCLUSION

Since most of the nurses do not have enough time for learning the system, and given that the selected scenarios for evaluation were based on the most frequent daily tasks that nurses performed using the NIS; The correction of usability problems in the scenarios 3 and 2 that had the highest number of problems and the scenario 5 that had the highest average severity and execution time; it can reduce the nurses' cognitive load and the learning time of the system and increase the efficiency of nurses.

Mobile technology to give a resource-based knowledge management advantage to community health nurses in an emerging economies context

Purpose

Knowledge is a key success factor in achieving competitive advantage. The purpose of this paper is to examine how mobile health technology facilitates knowledge management (KM) practices to enhance a public health service in an emerging economies context. Specifically, the acceptance of a knowledge-resource application by community health workers (CHWs) to deliver breast cancer health care in India, where resources are depleted, is explored.

Design/methodology/approach

Fieldwork activity conducted 20 semi-structured interviews with frontline CHWs, which were analysed using an interpretive inductive approach.

Findings

The application generates knowledge as a resource that signals quality health care and yields a positive reputation for the public health service. The CHW’s acceptance of technology enables knowledge generation and knowledge capture. The design facilitates knowledge codification and knowledge transfer of breast cancer information to standardise quality patient care.

Practical implications

KM insights are provided for the implementation of mobile health technology for frontline health-care professionals in an emerging economies context. The knowledge-resource application can deliver breast cancer care, in localised areas with the potential for wider contexts. The outcomes are valuable for policymakers, health service managers and KM practitioners in an emerging economies context.

Social implications

The legacy of the mobile heath technology is the normalisation of breast cancer discourse and the technical up-skilling of CHWs.

Originality/value

First, this paper contributes three propositions to KM scholarship, in a public health care, emerging economies context. Second, via an interdisciplinary theoretical lens (signalling theory and technology acceptance model), this paper offers a novel conceptualisation to illustrate how a knowledge-resource application can shape an organisation’s KM to form a resource-based competitive advantage.