Computerized Patient Information System

The Darbyshire (2004) article described the nurses and midwives experience to computerized patient information systems being implemented across five Australian hospitals during their everyday practice.  There was a significant amount of negative responses to this implementation.  This was a qualitative study which allowed nurses and midwives to describe their experience in their own words and there were many themes that emerged such as difficulty in using the software, in clearly articulating the nurses’ practice, in retrieving information, and no identifiable change in clinical outcomes. 

Based on these responses, it would be important to address both the technical and social elements that are described by the participants.  First, it would be important for the organization to support the nurses by offering in-service education that addresses workflows specific to accessing information in a timely manner and using the software effectively in their everyday practice.  This could be achieved by using specific case examples.  A study by McGuire et al. (2013) identified a implementation strategy that employed self-study, one-to-one sessions with super users, and in class training to support the staff.  They also provided on-site support during the first two weeks of initiating the electronic medical record (McGuire et al., 2013).  These strategies could support the technical elements of the system.  To address the social aspects, the staff may benefit from having a working group to talk about the current challenges they are facing and communicate these challenges to a super user or senior manager.   

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In the past three years my workplace has changed from a paper based documentation system to a computerized system.  This included a new online documentation system (electronic medical record; eMH) and a medication administration system (electronic medication administration record; eMAR).  Similar to the responses from the staff in the article, many of the staff at my workplace described the eMH and eMAR being difficult to navigate and use, inability to capture the essence of nursing, and incompatibilities between systems.  However, the attitude shifted after about one year of implementation and all staff are using the systems on a regular basis more competently.  At my workplace we had a lot of support from super users and were provided with opportunities for feedback and extra education if needed.

Darbyshire, P. (2004). “Rage against the machine?”: nurses’ and midwives’ experiences of using Computerized Patient Information Systems for clinical information. Journal of Clinical Nursing, 13(1), 17-25.

McGuire, M., Noronha, G., Samal, L., Yeh, H., Crocetti, S., & Kravet, S. (2013). Patient safety perceptions of primary care providers after implementation of an electronic medical record system. Journal of General Internal Medicine, 28(2), 184-192. doi:10.1007/s11606-012-2153-y

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1 Comment

  1. Great synopsis of the Darbyshire article. I definitely agree that education is needed when implementing new technologies, particularly now when we currently are in between a tech-savvy generation and one that did not begin their careers with much technology, if any. An article by Nguyen, Zierler, and Nguyen (2011) evaluated training needs of nurses and faculty when integrating new technology into education. Although guidelines and recommendations were set out for the incorporation of new technologies in order to adequately prepare nursing students entering practice, the implementation of new technologies has been both inconsistent and slow throughout the past 15 years (Nguyen, Zierler, & Nguyen, 2011). It was ultimately found that access to proper and adequate amounts of training for nurses and faculty greatly influenced the rate at which education technologies for nursing education and practice is used (Nguyen, Zierler, & Nguyen, 2011). It is clear that more effort needs to be put into educating current nurses as well as students on the most up-to-date technologies in order for all nurses to be technologically-literate.

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