Implementation and adoption of electronic documentation tools
by direct care nursing staff: A systematic review of the literature
by Susan Hall, RN
ABSTRACT
Context: Implementation of computer information systems in health care is a necessity, not a luxury, in pursuit of economical and quality care. As such there is a need to stimulate widespread adoption of computerized information systems in the clinical settings. Experience and empirical evidence shows that implementation of these systems has varied in results.
Objectives: To conduct a systematic review of the literature on clinical user attributes associated with acceptance of computerized information systems.
Data Sources: Five databases were searched and seventeen quantitative articles were retrieved that met the inclusion criteria.
Study Selection: There were no random control trials. All studies were descriptive and all but one was observational.
Data Extraction: Factors assessed included demographics, experience (nursing, computer), attitudes factors related to ease of use, barriers to use and impacts of use.
Data Synthesis: Findings indicate that there are multiple determinants of user adoption ranging from individual to environmental and organization factors and user attributes are changeable. Health care facilities are unique and context specific approaches for implementation projects are vital. Strategically addressing the important determinants of user acceptance within each context will ultimately impact on the implementation success rate. Therefore a multi-level intervention is necessary for successful implementation.
Conclusions: Further research and validation with multi-level intervention models are necessary.
ABOUT THE AUTHOR
Susan Hall, RN
Susan Hall is a direct care Registered Nurse with an extensive background in critical care, most recently as a member of the Post Anesthetic Care Unit at KGH. She is perusing part-time undergraduate studies in the Faculty of Nursing through Athabasca University and the Professional Learning Centre at the University of Toronto. She is a Leadership Fellow with RNAO and interested in barriers to the adoption of electronic documentation by nurses at the bedside. Susan was the 2004 recipient of the KGH Auxiliary Millennium New Technology Education Bursary.
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