Nurses place a high value on spending as much time as possible directly caring for patients. Optimizing the health system to allow nurses adequate patient-centered time is essential for improved patient experiences, improved health of populations, reducing the overall cost of healthcare, and improving the work life of health care clinicians and staff. As nurses are asked repeatedly to do more with less in a constantly changing and demanding work environment, it will be essential that technology is viewed by nurses as a partner. Pivotal to a successful integration of the technology is understanding nurses’ intentions to use the technology within their practice. The purpose of this research is to compare nurses’ perceived usefulness (PU), perceived ease of use (PEU), and workload burden for the Integrated Clinical System (ICS) and the icon-based electronic clinical dashboard system, INFUZE. The comparison of the nurses’ perceptions between the ICS and INFUZE, was conducted via a retrospective descriptive, comparative mixed-methods design using secondary data. Data from a private clinical database representing 189 registered nurses (RNs) practicing from September 2012 through December 2012 was used in the secondary data analysis. Data compared RNs’ perceptions of the current electronic health record (EHR) system and a home-grown (native) prototype called INFUZE. The dataset included quantitative measurement regarding usefulness, ease of use, and cognitive workload as measured by either a five-point (Technology Assessment Model [TAM]) or seven-point (NASA Task Load Index [TLX]) Likert scale. To complement and provide further insight, focus group data was also included and analyzed using a constant comparative and content analysis. The mixed-method design compared nurses’ perceptions of the availability of patient data between two systems and measured the need for timely access to pertinent patient data. New insights for clinical data use to support nurses were discovered. This descriptive, comparative mixed methods study compared nurses’ PU, PEU, and workload burden for the ICS and the icon-based electronic clinical dashboard system, INFUZE. The research approach used an extended conceptual framework, utilization the TAM and NASA TLX models and the inclusion of external variables of support resources, experience, demographics, and relevance to task. The secondary dataset included ICS (N=131) questionnaire data INFUZE (n=85) questionnaire data complete between September 19, 2012 and January 31, 2013. Transcripts of three voluntary focus groups were analyzed using content analysis methods to synthesize the feedback of 13 nurse participants. For PEU and PU, ICS was favored over INFUZE. For workload, INFUZE was favored over ICS. Focus group analysis revealed that there would be value in implementing an integrated dashboard interface if it is helpful in consuming actionable data rapidly; however, if it is not helpful, the interface would be irrelevant and/or burdensome. Furthermore, nurses considered the learning curve for new technology burdensome. In summary, the use of icons and/or dashboards tailored to the specific needs of nursing has potential to improve nurses’ experience, if the dashboard is a seamless part of the workflow and is integrated within existing technology. Further research is needed to understand human-computer interaction for specific interfaces in situ, toward the goal of developing an interface that is effective as an integrated and seamless companion to the core EHR.
University of Minnesota Ph.D. dissertation. June 2019. Major: Nursing. Advisor: Connie White Delaney. 1 computer file (PDF); viii, 113 pages.
Fratzke, Jason Jeffrey.
Nurses’ Perceived Comparative Usefulness between an Icon-based Electronic Clinical Dashboard and an Integrated Clinical System.
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