Impact of Healthcare Information Technology on Nursing Practice. 2015

Ronald J Piscotty, and Beatrice Kalisch, and Angel Gracey-Thomas
Theta Psi, Assistant Professor, Wayne State University College of Nursing, Detroit, MI.

OBJECTIVE To report additional mediation findings from a descriptive cross sectional study to examine if nurses' perceptions of the impact of healthcare information technology on their practice mediates the relationship between electronic nursing care reminder use and missed nursing care. METHODS The study used a descriptive design. The sample (N = 165) was composed of registered nurses working on acute care hospital units. The sample was obtained from a large teaching hospital in Southeast Michigan in the fall of 2012. All eligible nursing units (n = 19) were included. METHODS The MISSCARE Survey, Nursing Care Reminders Usage Survey, and the Impact of Healthcare Information Technology Scale were used to collect data to test for mediation. Mediation was tested using the method described by Baron and Kenny. Multiple regression equations were used to analyze the data to determine if mediation occurred between the variables. RESULTS Missed nursing care, the outcome variable, was regressed on the predictor variable, reminder usage, and the mediator variable impact of technology on nursing practice. The impact of healthcare information technology (IHIT) on nursing practice negatively affected missed nursing care (t = -4.12, p < .001), explaining 9.8% of variance in missed nursing care. With IHIT present, the predictor (reminder usage) was no longer significant (t = -.70, p = .48). Thus, the reduced direct association between reminder usage and missed nursing care when IHIT was in the model supported the hypothesis that IHIT was at least one of the mediators in the relationship between reminder usage and missed nursing care. CONCLUSIONS The perceptions of the impact of healthcare information technology mediates the relationship between nursing care reminder use and missed nursing care. The findings are beneficial to the advancement of healthcare technology in that designers of healthcare information technology systems need to keep in mind that perceptions regarding impacts of the technology will influence usage. CONCLUSIONS Many times, information technology systems are not designed to match the workflow of nurses. Systems built with redundant or impertinent reminders may be ignored. System designers must study which reminders nurses find most useful and which reminders result in the best quality outcomes.

UI MeSH Term Description Entries
D008297 Male Males
D009741 Nursing Staff, Hospital Personnel who provide nursing service to patients in a hospital. Hospital Nursing Staff,Hospital Nursing Staffs,Nursing Staffs, Hospital,Staff, Hospital Nursing,Staffs, Hospital Nursing
D003430 Cross-Sectional Studies Studies in which the presence or absence of disease or other health-related variables are determined in each member of the study population or in a representative sample at one particular time. This contrasts with LONGITUDINAL STUDIES which are followed over a period of time. Disease Frequency Surveys,Prevalence Studies,Analysis, Cross-Sectional,Cross Sectional Analysis,Cross-Sectional Survey,Surveys, Disease Frequency,Analyses, Cross Sectional,Analyses, Cross-Sectional,Analysis, Cross Sectional,Cross Sectional Analyses,Cross Sectional Studies,Cross Sectional Survey,Cross-Sectional Analyses,Cross-Sectional Analysis,Cross-Sectional Study,Cross-Sectional Surveys,Disease Frequency Survey,Prevalence Study,Studies, Cross-Sectional,Studies, Prevalence,Study, Cross-Sectional,Study, Prevalence,Survey, Cross-Sectional,Survey, Disease Frequency,Surveys, Cross-Sectional
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D001291 Attitude of Health Personnel Attitudes of personnel toward their patients, other professionals, toward the medical care system, etc. Staff Attitude,Attitude, Staff,Attitudes, Staff,Health Personnel Attitude,Health Personnel Attitudes,Staff Attitudes
D001292 Attitude to Computers The attitude and behavior associated with an individual using the computer. Attitude to Computer,Computer, Attitude to,Computers, Attitude to,to Computer, Attitude,to Computers, Attitude
D017010 Reminder Systems Systems used to prompt or aid the memory. The systems can be computerized reminders, color coding, telephone calls, or devices such as letters and postcards. Reminder System,System, Reminder,Systems, Reminder
D019300 Medical Errors Errors or mistakes committed by health professionals which result in harm to the patient. They include errors in diagnosis (DIAGNOSTIC ERRORS), errors in the administration of drugs and other medications (MEDICATION ERRORS), errors in the performance of surgical procedures, in the use of other types of therapy, in the use of equipment, and in the interpretation of laboratory findings. Medical errors are differentiated from MALPRACTICE in that the former are regarded as honest mistakes or accidents while the latter is the result of negligence, reprehensible ignorance, or criminal intent. Medical Mistakes,Surgical Errors,Critical Incidents, Medical,Critical Medical Incidents,Errors, Medical,Errors, Surgical,Medical Error of Commission,Medical Error of Omission,Medical Errors of Commission,Medical Errors of Omission,Medical Mistake,Mistake, Medical,Mistakes, Medical,Never Event,Surgical Error,Wrong-Patient Surgery,Wrong-Procedure Errors,Wrong-Site Surgery,Commission Medical Error,Commission Medical Errors,Critical Incident, Medical,Critical Medical Incident,Error, Medical,Error, Surgical,Error, Wrong-Procedure,Errors, Wrong-Procedure,Event, Never,Events, Never,Incident, Critical Medical,Incident, Medical Critical,Incidents, Critical Medical,Incidents, Medical Critical,Medical Critical Incident,Medical Critical Incidents,Medical Error,Medical Incident, Critical,Medical Incidents, Critical,Never Events,Omission Medical Error,Omission Medical Errors,Surgeries, Wrong-Patient,Surgeries, Wrong-Site,Surgery, Wrong-Patient,Surgery, Wrong-Site,Wrong Patient Surgery,Wrong Procedure Errors,Wrong Site Surgery,Wrong-Patient Surgeries,Wrong-Procedure Error,Wrong-Site Surgeries

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