The Netherlands Institute for Health Services Research (NIVEL), P.O. Box 1568, 3500 BN Utrecht, The Netherlands.
Int J Nurs Stud. 2010 Jul;47(7):846-54. doi: 10.1016/j.ijnurstu.2009.11.016.
A growing number of health care organizations are implementing a system of electronic patient records (EPR). This implies a change in work routines for nursing staff, but it could also be regarded as an opportunity to improve the quality of care.
The objective of this paper is to obtain more insight into the usefulness of EPR as perceived by nursing staff and to clarify the determinants of nursing staff's acceptance of EPR. Determinants were tested using an extended version of the Technology Acceptance Model.
Nursing staff members (NAs and RNs) completed a survey questionnaire about the use of EPR in health care, and their experiences, perceptions and attitudes regarding EPR.
All nursing staff members were working in Dutch hospitals, psychiatric organizations, care organizations for mentally retarded people, home care organizations, nursing homes or homes for the elderly.
The study population is a nationally representative Dutch research sample, further referred to as the Nursing Staff Panel. The Panel consists of a permanent group of Nursing Assistants (NAs) and Registered Nurses (RNs), who are prepared to fill in a postal questionnaire twice a year on average. In January 2009, 685 participants completed the questionnaire.
Nursing staff members associate EPR with improved care, especially qualitatively better and safer care. They also expect an increase in costs of care, while anticipating only a relatively small rise in the number of patients that can be cared for. In general, the effects of EPR on the work circumstances of nursing staff are expected to be negative. Job-related characteristics were found to be determinants of attitudes towards using EPR. A relatively positive attitude towards EPR was found in three categories of nursing staff in particular, i.e. staff working at least 30h per week, staff already using EPR and staff working in hospitals. Nursing staff in management positions also tend to have a more positive attitude. When the Technology Acceptance Model was tested, attitudes towards EPR were primarily associated with job-related characteristics and perceived usefulness with respect to quality of care.
The implementation strategies for EPR need to take account of the job characteristics of the intended future users. If implementation is to be successful, it is important that the users understand the beneficial effects of EPR on the quality of care.
越来越多的医疗机构正在实施电子病历系统（EPR）。这意味着护理人员的工作流程发生了变化，但也可以将其视为提高护理质量的机会。
本文旨在更深入地了解护理人员对 EPR 的实用性的看法，并阐明影响护理人员接受 EPR 的因素。使用扩展后的技术接受模型来测试这些决定因素。
护理人员（护士助理和注册护士）填写了一份关于医疗保健中使用 EPR 的调查问卷，以及他们对 EPR 的使用经验、看法和态度。
所有护理人员都在荷兰的医院、精神病组织、智障人士护理组织、家庭护理组织、养老院或老年人护理院工作。
研究人群是具有代表性的荷兰护理人员研究样本，进一步称为护理人员小组。该小组由一组固定的护士助理（NA）和注册护士（RN）组成，他们平均每年准备填写两次邮寄问卷。2009 年 1 月，有 685 名参与者完成了问卷。
护理人员将 EPR 与改善护理联系起来，特别是在质量上更好和更安全的护理。他们还预计护理成本会增加，而预计可以护理的患者数量只会略有增加。一般来说，EPR 对护理人员工作环境的影响预计将是负面的。与工作相关的特征被发现是对使用 EPR 的态度的决定因素。在特定的三个护理人员类别中发现了对 EPR 的相对积极态度，即每周至少工作 30 小时的工作人员、已经使用 EPR 的工作人员和在医院工作的工作人员。担任管理职位的护理人员也往往持更积极的态度。当测试技术接受模型时，对 EPR 的态度主要与工作相关的特征和与护理质量相关的感知有用性相关。
EPR 的实施策略需要考虑到预期未来用户的工作特点。如果要实施成功，重要的是让用户了解 EPR 对护理质量的有益影响。
