Peer Reviewed Nursing Journals How Technology Impacts Nursing
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Nurses' experiences and viewpoints about the benefits of adopting it in health care: a qualitative study in Iran
BMC Medical Informatics and Conclusion Making volume 20, Article number:240 (2020) Cite this commodity
Abstract
Groundwork
Information engineering science (It) plays an important office in nursing practice. Hence, nurses' experiences and viewpoints about Information technology integration into healthcare assist meliorate nurses' adoption of It. This study aimed to explore the nurses' experiences and viewpoints most the benefits of IT integration and adoption in healthcare.
Methods
This report was conducted with a qualitative enquiry approach. Participants included fourteen nurses from iv hospitals affiliated to a big medical university in Iran, who were selected using a purposive sampling method. Data were collected through semi-structured interviews and analyzed using the conventional content analysis of Lundman and Graneheim.
Results
Vi categories in the study reflected the nurses' experiences and viewpoints about the benefits of integrating Information technology into health care. These categories included improving the quality and efficiency of medical services and care, facilitating the communication management in the technological environment, improving information documentation, management, and monitoring, improving resource management, improving direction performance and policymaking, and facilitating pathways of organizational and professional growth.
Conclusions
Lessons learned in this study tin can help overcoming the barriers of IT adoption, and developing advisable strategies to familiarize nurses with the benefits of It in healthcare settings. Healthcare managers are recommended to investigate the experiences of nurses with Information technology in their hospitals and organize courses to orient hesitant nurses toward adopting It.
Peer Review reports
Background
Information technology (IT) has transformed healthcare and nursing in several aspects including clinical, management, teaching and research areas [1]. Nurses' adoption of Information technology is disquisitional to integrate It successfully in the nursing fields [two]. Research conducted on IT adoption in healthcare has focused on two main areas. Kickoff, researchers extensively documented that introduction of IT into clinical settings, and nurses' adoption of Information technology have positive effects or benefits for many nursing care aspects. For example, it has influenced time management of documentation and clinical activities, quality of documentation, nurses' competencies and empowerment, and quality of intendance. Moreover, it improved intra- and inter-professional collaboration, nurse-patient relationship, teaching of patients and families,, and nurses and patients' satisfaction [3].
Second, despite widespread efforts for facilitating It adoption and presenting positive impacts or benefits of integrating It into healthcare, several studies reported that nurses accept not adopted such tools completely [4,5,6,vii]. At that place are still some barriers (eastward.m. underutilization and reluctance to use It, sabotage, nurses' resistance to It implementations, and unfavorable attitudes toward IT) to the successful interaction of nurses with Information technology in health care, and fitting Information technology into the workflow of nurses is challenging [6, viii]. The lack of IT adoption can result in unintended negative consequences such equally anxiety, fear, a want to return to newspaper system [9], deterioration of piece of work weather and quality, dissatisfaction, cognitive overload, exhaustion and sense of ineffectiveness [10]. Other reported consequences are the failure of It implementations, or suboptimal user-system interactions, which in plow lead to nurses' frustration, and adverse patient outcomes [xi].
IT adoption can be reinforced by facilitating factors such every bit minimizing nurses' discomfort about Information technology, exploring and agreement nurses' feel about positive impacts and the benefits of integrating IT to their exercise [6, 12]. On the other hand, the literature showed that IT adoption may vary profoundly amidst different types of organizations and countries. Information technology is also affected by cultural, socio-organizational factors, and demographic features such equally hospital size, blazon of hospital (whether information technology is educational or non), ownership, location or area (urban or rural), upkeep, rate of IT staff, nurses' awareness of the benefits of IT, and their Information technology competencies [13,14,fifteen]. Therefore, qualitative studies presenting nurses' experiences and viewpoints about the benefits of adoption of Information technology to diverse contexts volition be worthwhile [16]. Moreover, most studies take used quantitative approach and investigated the impacts related to the adoption of IT in hospital settings. Few qualitative studies in various countries explored nurses' experiences and viewpoints with It implementation, facilitators and barriers to IT adoption. In the studies, the nurses mentioned both negative and positive experiences and viewpoints well-nigh It adoption. Lack of training and awareness about the potential benefits of IT contributed to the negative experiences of the nurses. Researchers concluded that managers should refine policies to reflect benefits of Information technology in nursing practice. Previous studies recommended conducting further inquiry to explore perceived benefits of It adoption in different contexts [2, 17, eighteen].
The studies investigated barriers, facilitators, positive and negative impacts of It adoption on health intendance. We found no comprehensive, qualitative study exploring the nurses' experiences and viewpoints virtually the positive impacts or benefits of It adoption in healthcare system of Islamic republic of iran. On the other hand, according to McKibbon, quantitative studies provide answers or insights for many important questions or issues in healthcare and clinical research. Other important questions dealing with why, how, contexts, and experiences of individuals or groups, can be best addressed using qualitative methods. Qualitative studies provide insight into social, emotional, and experiential aspects of healthcare [19].
It has become a key role of nursing practice and using Information technology applications is 1 of the most of import responsibilities of nurses [i]. Therefore, the objective of this study was to explore nurses' experiences and viewpoints well-nigh the benefits of IT integration and adoption in hospitals in Iran using a qualitative approach. The lessons learned from this study, and sharing nurses' experiences concerning Information technology adoption could be useful for other nurses.
Methods
Blueprint and settings
This report was conducted using a conventional, qualitative, content analysis method. The content analysis approach is a method for systematic and dominion-guided classification and clarification of text material considering words, phrases, latent contents and contexts [20].
The settings for this study were four teaching and referral hospitals affiliated with Kerman University of Medical Sciences located in Kerman. Kerman is the largest city in southeast Iran with 800,000 inhabitants. These hospitals receive patients from southeast of Iran, within the radius of 500 km. Different high-tech medical and surgical interventions are conducted in these hospitals by nursing and medical staff who collaborate with university-based medical scientists in educating healthcare students. Authorities of Kerman Academy of Medical Sciences select appropriate e-Wellness applications for the hospitals. These hospitals have more than than 20 years of experiences of using IT and are among IT pioneers in Iran. All healthcare policies implemented in hospitals are centrally fabricated past Iranian Ministry building of Health. The political calendar is currently paying more attention to application of e-Health, and all hospitals are actively implementing Hospital Information Arrangement (HIS). HIS is used to automate infirmary tasks such as toll management, resource direction, medication management, part automation, accounting, nurses and physicians' performance assessment, and patients' registration.
The distribution of nurses is similar in all the hospitals throughout Iran. The majority of nurses accept bachelor's degrees and the recruitment of nurses follows the same pattern in all the hospitals. Nurses in the organizational nautical chart of the hospitals are classified into five principal positions including matron or nurse managing director, clinical and educational supervisors, caput nurse, and nurse or clinical nurse. Normally nurses rotate amidst different clinical wards co-ordinate to the decision of the matron. Hence, all nurses involved in our study had at least experience of working in more than than one clinical ward, No registered nurse (RN) and informatics nurse specialist are currently working in the study settings. There are currently no policies in place addressing nursing information science competencies for nurses. Normally, after the implementation of a HIS, nurses receive both cursory medical informatics and regular computer preparation. Also a brusque training is provided in the wards when new functionalities are released. Each hospital has an Information technology department. It staff working in the IT departments of the hospitals have plenty knowledge of all aspects of e-Health applications and guide the nurses during the Implementation of the HIS. HIS in-service grooming is currently done in clinical wards for the new nurses.
Participants and sampling
A purposive sampling method was applied, and 14 nurses were selected to participate in this study (Table 1). In each hospital, the first researcher, with help of nurse managers, selected a number of eligible participants. She asked the nurse managers to suggest nurses who would be representative of their peers and to speak with openness. The sampling procedure was continued based on the principle of maximum variation to capture rich and diverse perspectives and experiences of the participants. Therefore, nurses with different genders, ages, years of work experience, degrees, positions, and clinical wards were enrolled until data saturation. All of the selected interviewees had several years of work experiences in their professions. They were normally working with IT such as a HIS and most of them take been working with newspaper-based systems for several years.
Data drove
Data collection was performed through open-ended semi-structured interviews. The starting time researcher, a PhD nurse, who had a groundwork in clinical nursing and experienced in-depth interview for qualitative studies, conducted all the interviews. She went to different wards, explained the report objectives to nurses, invited them to participate in the study, and scheduled an interview date. All interviews were conducted face-to-face, audio recorded and transcribed. Topic-guide questions were adult based on specific report objectives through consensus of the research grouping who were faculty members of nursing and medical informatics. Initially, a serial of stimulus questions were designed and asked to create a friendly atmosphere and to prompt responses of the participants in the qualitative techniques. Then, the interview questions sought nurses' experiences and viewpoints near the benefits of Information technology adoption in healthcare. Some of the guide questions are as follows: what are the benefits of IT adoption in healthcare or in nursing do? Does healthcare and nursing practice improve when using IT? How? Do you think that IT has changed healthcare? If aye, please explicate the changes due to the utilise of Information technology compared with the newspaper-based organisation. Then the interviewer asked follow-up probing questions to analyze relevant avenues of inquiry raised by the participants and to arm-twist nurses' experience and deeper narrations, such as "please explain more than nearly …".
Interviews with nurses were conducted in their hospitals after receiving their consent, and they were organized in a style not to disrupt daily schedules of the participants. The interviews took 40–65 min in a serenity room near the ward or some other location in hospitals based on the participants' preference.
Data assay
The data were analyzed based on instructions proposed by Lundman and Graneheim [21]. In the first footstep, every interview was transcribed verbatim by the first researcher. In the next footstep, ii researchers (JF, LA) read the transcriptions several times to obtain an overall understanding of the content, make up one's mind meaning units, perform an initial coding and interpret the data individually. The two researchers manually merged codes and classified them based on their similarities, and established sub-categories and categories independently. Then, they developed the coding scheme (lawmaking name, code definition, categories, subcategories, and text examples, and coding rules). In this procedure, the researchers met regularly to discuss about agreements and discrepancies of assigned codes, categories, subcategories, and rationale. Coding disagreements > 5% were discussed by the research team to reach consensus and the coding scheme was revised. Initial agreement on coding was high (92%), and the researchers discussed their interpretations to further refine concepts and resolve disagreements until achieving a consensus. Finally, all researchers reviewed coding scheme and triangulated them which formed the terminal coding scheme. At each consensus meeting, to assess coding agreement, nosotros calculated the percentage of agreement for the almost frequently coded sections of the transcripts. Coding understanding and inter-coder reliability were obtained when both coders assigned the same code to the main idea of a segment from a transcript. The overall inter-coder reliability for the transcript was high (91%) [20]. Moreover, two external experts specialized in qualitative research reviewed and canonical the coding process and categories. Coding and data assay were conducted using MAXQDA10 (qualitative data analysis software), which enhanced the comprehensibility of the analytic procedure.
The trustworthiness of the information was determined using Lincoln and Guba' criteria, including credibility, confirmability, dependability, and transferability [21]. To ensure these criteria, the researchers were constantly working on the data, were in contact with the participants for 1 year, and established a friendly human relationship with the participants. Furthermore, summaries of the interviews and results were presented to participants, and they were asked to provide feedback on the findings. The co-researchers continuously reviewed and verified the coding and categorization methods in frequent meetings and the findings were assessed in the context of prior literature. In addition, we presented our findings to the nurse manager of each hospital and used their comments for the interpretation of the findings.
Results
Demographic information
The participants included two caput nurses, eight clinical nurses, 2 educational supervisors, a clinical supervisor, and a quality improvement officer. The nurses were nine women and five men aged 27–55 years with work experiences ranging from 2 to 30 years. 5 nurses had a master'southward degree and the others had a bachelor's caste in nursing (Tabular array 1).
Results from interviews
In the analysis of the 14 interviews, six categories and 21 subcategories emerged (Tabular array 2). Results along with quotations presented by participants are described in the following.
Improving the quality and efficiency of medical services and care
Reducing clinical risks and error
According to the nurses, the care provided through Information technology is more accurate and have a higher quality and prophylactic. IT gives nurses a sense of control over the patients' condition and reduces clinical risks and errors.
"When the patient'southward claret group is recorded every bit O + in the HIS, errors of the laboratory staff are largely prevented." (p 12)
Application of IT likewise has decreased medication errors and improved drug management, and created an integrated medical fault reporting organization.
"When an error occurs, we fill up in the online fault reporting forms. The error assay authority shares online corrective mistake strategies with all wards. Before this organisation, nurses wasted a lot of time on writing paper forms, now the forms are in the computer which brand reporting and analyzing much easier." (p3)
Increasing staff safe
Regarding access to integrated information of the patients' status provided by HIS, nurses accept a feeling of confidence and peace of heed. They have control over the state of affairs, considering all documentations are available and these documents cannot exist manipulated or deleted from the HIS.
"A CT browse was fabricated in the emergency ward, but it was lost in the surgery ward. The IT department adamant that the CT scan was removed from the patient profile in the internal medicine ward; so, the personnel of surgery and emergency wards were acquitted." (p1)
Improving decision-making efficiency
IT plays a major role in providing the required and valid information for the decision-making process of the healthcare team. For example, awarding of It can reduce the time needed to transfer information to the healthcare team and decisions are made timely with a maximum efficiency.
"The patient was not feeling well and we informed the dr. about the patient's condition directly and the necessary measures were taken within an appropriate time. Documentation with HIS can facilitate this process inside a few minutes." (p10)
Maintaining continuity of care
One of the most basic responsibilities of health care team is to maintain continuity of care. It leads to continuity of care, for example, with providing quick access of physicians to the results of diagnostic and laboratory tests and graphs. Therefore, time is saved and the handling and intendance process is not delayed. Another do good of Information technology is protection of patients' data during the delivery of shifts, acceleration of shifts' delivery, and reduction of delays in the care procedure at the time of shift change.
"Physicians tin can easily enter the patient's national code at the dispensary and observe a CT scan or Ten-ray report. They can diagnose the illness and start the medications very quickly." (p2)
Improving workflow (piece of work process) and planning care
Rapid access to patients' information such equally the results of para-clinical test accelerates the work process and improves the nursing care and handling plans. Finally, the health care team'south satisfaction increase.
"At night, the physician observed the X-ray results of a patient in her part using the Movie Archiving and Communication System (PACS) and started the medication procedures immediately." (p2)
"With the help of HIS, the patients' discharge process is facilitated, and we ready the bed for the next patient apace." (p.9)
Facilitating the communication direction in the technological environment
Improving inter-organizational communications
Accurate communication and timely transmission of information are necessary in healthcare settings. Information confirmation and reception is piece of cake and constructive when it is washed simultaneously between care teams in different departments of the infirmary. For case, electronic health records (EHR) take created a wide communicational system betwixt therapeutic wards and para-clinical units such every bit pharmacy, radiology, support, revenue, admission, and belch. Furthermore, Information technology facilitated advice of care team with patients and increased their trust on the intendance team.
"I fill out the equipment breakdown form in the HIS; the equipment authority sees information technology in his system simultaneously and comes to fix information technology fast. Moreover, all the personnel in the ward know about the damaged equipment and the time of their fixation." (p5)
Improving and expanding the intra-organizational communications
Nurses explained that health information of individuals is stored in an EHR throughout their lives. Therefore, in case of a treatment requirement anywhere in the country, the individual's contour volition be accessible through a computer network using the national code. In improver, It has facilitated transfer of data to the Ministry of Wellness and amidst other hospitals and healthcare organizations.
"When a meaning mother's death scenario is entered into the national maternal deaths system from a hospital, the Ministry of Wellness immediately investigates the case and makes plans at the macro level to reduce maternal deaths. So, the related instructions are sent to all the hospitals of the country." (p 12)
Improving data documentation, management, and monitoring
Benefitting from simultaneous documentation and care
Today, simultaneous documentation with care aid nurses record care events on time. In the same vein, IT help provide careful and comprehensive care, reduce the time required to document reports, and increment the available time to provide direct care to patients.
"The patients' history in EHR helps the triage; when the patient has a cardiovascular disease, I will prioritize him/her and inform the physician. I also take emergency measures such as tests." (p2)
Nurses pointed out that admission to a comprehensive fix of information about patients could speed up nursing process. Still, the nursing process and nursing classifications such as nursing diagnoses, the nursing interventions classification (NIC) and the nursing outcomes classification (NOC) which is applied internationally for documentation of nursing records, and care plans are however paper-based in the written report settings. They expressed a desire to take benefit of Information technology and have the classifications in electronic format in HIS.
Increasing data and documentation accessibility
If the data are non available in a timely manner, their capture will be useless. All information should be readily accessible at the time of demand for clinical, authoritative, and organizational purposes. Farther benefits of Information technology include speeding upwardly access to previous records of patients, increasing the accuracy of patients' information registration, increasing the accuracy of hospital information, receiving daily statistics and reports, and reporting hospital income and expenses.
"When we want to run across the changes in the hemoglobin levels of the patient with bleeding from the time of admission, nosotros simply open the system and compare the test results. However, if we wanted to search the paper files, the test results would be unavailable, lost, or unordered." (p1)
Increasing integrity of information
Registration of all information in the HIS and recording all care processes have ensured the integrity and uniformity of the data. This data can exist used for treatment, enquiry, and planning. Many of these data, such as nosocomial infections and adverse events are sent to the Ministry building by electronic systems.
"HIS provides a rich network of data for the infirmary to conduct research, and managers can calculate a lot of indicators using this information." (p 13)
Creating a precise and secure archive of documents and information
Participants also pointed out that It has created a convenient and secure archive for documents, so that information and documentation will never be lost.
"The paper files may be torn or destroyed by events such as fire. However, it is easier to find documents and view statistics in the electronic archive, and there is no risk of missing data because the IT section often makes backups of information." (p11)
Improving resource direction
Reducing workload and paper piece of work
Participants highlighted the important benefits of It in reducing paperwork and staff's chore load also as saving paper consumption.
"In newspaper work, we used to spend much time to keep the documents without folding papers. For example, we had to send a large number of paper requests for blood of the patients of cesarean section daily. Many of these requests were returned because of errors and thus turned into waste product. All these are at present electronic and such bug are no more bachelor." (p14, p1)
Saving not-nursing staff
As the findings show, It saves non-nursing homo resources. For case, it reduces staff movement amid wards. Previously, most not-nursing personnel were constantly moving between wards to deliver documents. Today, however, information is easily exchanged with IT and most not-nursing personnel tasks are done by IT.
"We used to regularly send nursing staff to accept test request with the samples for example the laboratory requests, simply now we can see the results quickly in the HIS." (p10)
Optimizing and purposeful activities
Application of Information technology has reduced many repeated and unnecessary tests and measures. As a outcome, the brunt on family caregivers has reduced.
"Formerly, a lot of patients' Ten-rays were disposed or archived at a great toll. However, the PACS saves both patients' and hospitals costs. Calculation of expenses is much easier and no service tape is eliminated or thrown away". (p2)
Nurses also believed that with IT, many targeted measures were carried out without time filibuster and cost.
"Our social workers open the HIS in their room and cheque which patients demand assistance. Then, every day they become to the target patient purposefully." (p11)
Saving time and costs
Nurses described IT as a facilitative factor in rendering care services, speeding up tasks, and saving costs and fourth dimension for patients and nurses. In add-on, It provides the opportunity for nurses to spend more time with patients.
"Previously, when nosotros wanted to go information from head nurses or sent a alphabetic character to them, an individual should deliver letters or collect responses from all wards. This process was very long and time consuming. Now, head nurses tin encounter the letter at the aforementioned fourth dimension in HIS." (p11 and p12)
Improving management operation and policy making
Reinforcing a dynamic and responsive structure
Plenty information and statistics are beneficial for senior managers to make timely, logical, and specialized decisions and policies. It has led to timely detection of shortcomings, fast access to financial and organizational reports, accurate reporting and accountability to executives, and appropriate communication with fiscal managers for mid-level and operational executives. Moreover, Information technology helps control functioning and strengthens accountability and responsiveness of employees, since records and documents are firmly recorded for all actions with engagement and fourth dimension.
"The HIS is an audit organisation. So, staff should pay attention not to lose sheets of paper in the patient's profile and physicians are committed to protect the graphs and services they carry out, considering no service can be eliminated, and they must be responsive.") p3)
Improving accreditation and audit
IT has facilitated quality improvement actions such as auditing and accreditation through the inter-organizational communication network. All information concerning the implementation of piece of work processes, policies, indicators, and reports of patient rubber events are recorded and monitored. So, the relevant documents are used for accreditation and audit purposes.
"Nosotros accept created a folder called "Accreditation Standards" in the HIS for all departments and shared all accreditation deportment in this folder. Personnel review this binder, complete the forms related to accreditation actions, and send them to us." (p11)
Facilitating the staff' operation evaluation
Managers demand valid information to control, monitor, and evaluate personnel'due south duties, which are facilitated by IT. Moreover, staff's self-assessment and participation in the process of performance evaluation is mentioned every bit another benefit of It.
"All staff should upload and submit their self-assessment documents in an electronic evaluation system. Finally, staff's performance evaluated by the nurse director is observable in electronic profiles." (p13)
Facilitating pathways of organizational and professional growth
Creating aspiration to ameliorate the informatics competencies
Nurses believed that with combination of technological advances in nursing practice, they must acquire and update their computer science competencies in various means, such as learning from colleagues, participating in grooming courses inside and exterior the system, and self-directed learning.
"I became more than enthusiastic virtually updating my informatics competencies. I tried to attend educational courses inside and exterior the hospital. If I had any bug, I would inquire my colleagues or the IT department staff in the hospital or grouping discussion sessions" (p4)
Enhancing virtual grooming and facilitating the training process
IT boosts training in medical professions in both virtual and classroom learning. For instance, electronic commutation of patients' files between dissimilar handling centers, discussions almost diagnosis and treatment of patients, and awarding of patients' data such as results of X-rays at preparation sessions assistance the individual and professional person development of the health intendance team. Moreover, by application of the virtual learning organisation, personnel are non always required to attend the classes.
"In one ward, a patient had a blood transfusion trouble; the novice nurse did not know what to do. I told him, on the telephone, to refer to the blood transfusion binder, read the instructions how to manage blood transfusion problems, and to take the necessary action." (p14)
Participants also believed that the process of grooming and completing personnel training records is much faster and less costly with It.
"I enter the educational program in the system each month and the personnel sign up for the classes they need. At the terminate of each form, they will receive certificates." (p13)
Developing technology according to the needs of healthcare providers
The deficiencies of It will be detected while nurses are using it. Nurses and nurse managers have an effective role in determining deficiencies when developing Information technology by conducting periodic reviews to detect problems in healthcare because of deficiencies in Information technology.
"In the previous version of HIS, some codes, such as bronchoscopy of lung parenchyma, were not defined for our ward. However, the new version added these capabilities. Gradually, defects were corrected and patients and nurses are more comfortable." (p5)
Discussion
The present study explored nurses' experiences and viewpoints about the benefits of It integration and adoption in healthcare. The results depicted a movie of various beneficial outcomes of IT in nursing practice classified into half-dozen categories. One of the categories was "improving the quality and efficiency of medical services and care". The findings of our study are in agreement with previous studies on IT adoption and implementation in a multifariousness of settings. For case, our results have confirmed the findings of a systematic review that aimed to evaluate the influence of eHealth on nursing intendance. This review study reported that the use of It past nurses tin affect their practice, modify the ways in which they plan, provide, document, and review clinical intendance and finally improve the quality of care provided and patients outcomes [3]. Other studies accept also reported that It adoption increases the quality of patient care and improves the standards in healthcare organizations [half-dozen] by supporting clinicians in making clinical decisions efficiently [22,23,24]. Moreover, it reduces the risk of making errors by decreasing the clinicians' cognitive workload, synthesizing and organizing information in accessible and usable formats [25]. IT improves providers' functioning past reducing delays in intendance at the time of shift alter and maintains continuity of intendance [23].
Our study participants frequently expressed development of an integrated medical error reporting system every bit an important benign consequence of It adoption. These systems are considered among essential factors for implementing patient prophylactic plans and also the well-nigh of import steps to learn from errors and previous experiences. This outcome was not examined fairly in the previous studies. Unlike our results that It improves patient outcomes, there are controversies about benefits of It in the studies [24, 26]. Varghese et al. reported problems and unintended consequences of IT implementation such as errors and delays in clinical decision-making, and actual or potential patient harm considering of technical and sociotechnical or context factors [24].
In the present written report, "facilitating the communication management in the technological environment" along with its subcategories was identified as another perceived do good for IT. Similarly, two studies maintained that IT improved communication between/amongst wards and staff [23, 27], teamwork and team support [25]. A systematic review on this topic reported several themes, including the touch on of EHR on data exchange between patients and clinicians; maintaining positive relationships, and partnering with patients; and the EHR as an amplifier of existing advice behaviors [28]. Another systematic review explained that Information technology had both positive and negative impacts on advice. Negative impacts were every bit follow: clinicians should separate their attention by the patient and reckoner, had difficulty in maintaining eye contact, and other aspects of patient-centeredness. This literature review suggests that by applying appropriate strategies, IT can support patient-clinician interaction rather than interfere with it. These positive impacts included improving nurses' communication skills, increasing information sharing between patients and clinicians and increasing opportunities to engage with and to empower patients by sharing computer-based data and resources with them and providing opportunities for patients to ask questions and providing more information to the clinician. These positive impacts depends to a large extent, on nurses' styles of interacting with IT and patients as well every bit how they adapt to apply It in the workflow [7]. In our study, participants emphasized on theme of expanding the intra-organizational communications, which was less reported in the mentioned review manufactures. Nosotros recommend that nurses use Information technology for the patient care by adopting some of the strategies such as learning the exact and nonverbal cues to support their interactions with patients. For this purpose, educators tin develop interventions and educate nurses how to integrate Information technology into clinical settings.
Another perceived benefit for integration of IT in healthcare system was improving information documentation, direction, and monitoring along with its subcategories. The findings of our report support a previous systematic review that evaluated the impact of information and communication technologies on nursing care [3]. Another study also showed that IT could manage patients' information, increment the legibility of recorded information, increase patients' security of information and documents, increase data accessibility, and improve accuracy of information and activities [23]. Moreover, Saranto et al. explained that IT has facilitated the apply of international nursing classification such equally nursing diagnoses, NIC and NOC, which accept been translated into various languages for providing patient intendance and documentation of the nursing procedure. Nursing classifications as a standardized nursing linguistic communication (SNL) take been adult to depict the nursing process, to document nursing care and to facilitate aggregation of information for comparisons at the local, regional, national and international levels. Therefore, these classifications should exist linked to one other in HER. Researcher reported that many countries transferred paper-based to electronic documentation and used SNL in electronic nursing records [29]. In our report, nurses were concerned almost using present data systems or electronic nursing records that practice not support SNL nursing classifications. Nurses suggested that SNL should be created and linked to ane other in HIS to track nurses' contributions to patient care electronically.
"Improving resource direction" with subcategories was another perceived benefit for integration of IT in healthcare. These results were in understanding with previous studies that reported the benefits of It adoption such as reduced treatment costs and resources, reduced task fourth dimension and increased working speed, faster transmission of lab test orders, reduced staff movement between wards, reduced paper work and consumption, reduced workload, improved review of patients' records to plan their care, improved commutation of information, increased infirmary revenue [23]. Other studies also showed that the data collected with HIS are clear, attainable, consummate, timely, and relevant [30], reduce burden on family caregivers [31], and repeated imaging [32]. In other words, healthcare professionals tin can use these data to provide high-quality services, and managers are able to manage their resources, including staff and tools, more efficiently [xxx]. The IT benefited nurses by helping them perform their daily tasks with greater ease, and it made the nurses' work more effective. IT improved nurses' efficiency by reducing resource consumption and facilitating information access, recording, and processing [33].
Some other category emerged from interviews was "improving direction performance and policy-making" with subcategories. These results were in agreement with studies that reported nurses' adoption of HIS had the potential to influence on policy-making and management of nurses who used such technologies at work [16]. Similarly, empirical studies of nurses' IT adoption showed that IT contributed to improving accreditation, inspect, management performance [23], increasing accountability, and responsibility [34] .Another research showed that It was very advantageous for quality control, quality balls, process monitoring, and process optimization programs [30]. Rahimipour et al. noted that It is an important office of the staff empowerment procedure and improvement of human resource capabilities. In addition, IT increases staff'south noesis, creativity, and quality of operation [35].
The other category extracted in this written report was "facilitating pathways of organizational and professional growth" with subcategories. In this regard, previous studies reported that enhancing informatics competencies are important for the acceptance of HIS and like technologies [sixteen, 36]. In addition, researchers emphasized that IT plays an important role in pedagogy and nursing work. IT has created opportunities for utilization of e-learning and teaching, improvement of grooming services, public education, patient and their families' pedagogy. Information technology has increased admission to resource and educational content at any time and identify, saved time and cost and created more than opportunities to learn unlike ways and improve the quality of didactics and standard of nurses grooming [1, 17, 37]. Another report found that the adoption of Information technology by healthcare providers contributed to gradual arrangement evolution [34], improved EHR design [25], and stimulated users to add useful functions to the system [38]. In a study by Zakane et al. nurses argued that the application of a clinical decision support system increased their cognition, and these systems could exist used as continuous grooming for nurses [39]. Blank et al. also showed the positive impacts of nursing decision support system on the improvement of nurses' skills and noesis [twoscore]. According to our findings, nurse mangers provide opportunities for nurses and use multiple educational pathways to equip them with required competencies for IT adoption to nursing exercise. Moreover, schools of nursing must prepare students for It adoption through competency-based approaches, reexamination and updating nursing curricula based on new IT advances, and changes in the needs of patients and the healthcare organization.
In total, the results of this study may be somewhat similar to other studies. However, there are the discrepancy between some of our results and the above-mentioned studies. These can be due to the differences in customs, sampling written report design, technical and socio-organizational or context factors. For example, in our study, a qualitative design was used to explore the deep experiences of nurses from the benefits of Information technology adoption. Nosotros suggest that future studies employ a standard approach to examine the effect of these sociotechnical contextual variables, also as system, man and other key factors on the It adoption and their contribution to positive outcomes such as quality and condom.
Limitations
The written report had several limitations. Starting time, this study explored benefits of IT adoption based on the experiences of nurses working in the healthcare arrangement of Iran, and information technology is hard to generalize the findings to all professional groups or other context. Other benefits may exist perceived in different cultural and organizational contexts, with other groups, e.thousand., physicians, and even from a multidisciplinary perspective. 2nd, this study did not focus on negative experiences or viewpoints of nurses most IT adoption. However, the nurses mentioned negative impacts of IT during the interviews that were non within the scope of this written report. Future studies should endeavor to overcome the mentioned shortcomings associated with this study. In this regard, we suggest conducting further studies exploring positive and negative impacts of It adoption in different cultural and organizational contexts, with other groups. Third, nosotros did not compare nurses' perceptions of newspaper and electronic organisation; quantitative studies tin supplement a qualitative written report to explore the benefits of integrating Information technology compared with using newspaper systems. Such comparative studies will increment the reliability of the results and will assist researchers achieve comprehensive results and enrich insights.
Conclusions
Understanding of nurses' experiences and viewpoints virtually benefits of It and lessons learned in this report can contribute to the Information technology adoption, overcome the barriers, and develop appropriate strategies to orient nurses towards the benefits of Information technology adoption in healthcare settings. The results propose that the healthcare managers invite nurses from the studied hospitals to share their positive experiences and utilize them to develop appropriate strategies and policies for improving Information technology adoption amidst nurses and other medical professions. When nurses are hesitant or have a negative feeling, managers can organize courses for orientating a positive direction. Furthermore, researchers tin explore factors that enhance nurses' adoption of new IT in the research surface area and other contexts. Probably, providing users with positive feedback, technical back up, and proficient training programs can help designers facilitate It adoption. Regarding the expansion and specialization of nursing, nursing information science experts should be recruited to promote the services provided past nurses in educational, research, clinical, and managerial areas.
Availability of data and materials
The information analyzed in this study is not included in a repository because it contains interview transcripts.
Abbreviations
- IT:
-
Information technology
- PACS:
-
Moving-picture show Archiving and Advice System
- HIS:
-
Hospital Data System
- HER:
-
Electronic wellness records
- SNL:
-
Standardized nursing language
- NIC:
-
Nursing interventions classification
- NOC:
-
Nursing outcomes nomenclature
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Acknowledgements
The researchers capeesh all the nurses who gave their fourth dimension and then generously to participate in the written report.
Funding
This research received no specific grant from whatever funding agency in the public, commercial, or non-for-profit sectors.
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JF, RK, AH, and LA contributed to conceiving and designing the research. The information were collected, analyzed, and interpreted by JF, RK, and LA. JF, RK, AH, and LA contributed every bit to writing and revising the manuscript and approved the final manuscript.
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Ethics blessing and consent to participate
This study was approved by the Ethics Commission affiliated with Kerman University of Medical Sciences (IR.KMU.REC.1395.435). Then, oral and written informed consent was obtained from the nurses before recording the interviews. The nurses were informed that participation in the written report was voluntary. Furthermore, nurses were ensured about the information confidentiality. The researchers likewise asked the nurses to telephone call or send an email in case of having any questions or misunderstanding.
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The authors declare that they accept no competing interests.
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Farokhzadian, J., Khajouei, R., Hasman, A. et al. Nurses' experiences and viewpoints nearly the benefits of adopting information technology in health care: a qualitative study in Islamic republic of iran. BMC Med Inform Decis Mak 20, 240 (2020). https://doi.org/10.1186/s12911-020-01260-v
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DOI : https://doi.org/10.1186/s12911-020-01260-5
Keywords
- Adoption
- eHealth
- It
- Nurses
- Qualitative arroyo
Source: https://bmcmedinformdecismak.biomedcentral.com/articles/10.1186/s12911-020-01260-5
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