Sockolow Paulina S, Weiner Jonathan P, Bowles Kathryn H, Lehmann Harold P
College of Nursing and Health Professions, Drexel University, Philadelphia, PA 19027, USA.
Comput Inform Nurs. 2011 Oct;29(10):574-85. doi: 10.1097/NCN.0b013e31821a1568.
A new survey instrument was developed and validated to measure clinician (nurse) satisfaction with electronic health record impact on clinical process. The Health Information Technology Reference-Based Evaluation Framework guided the selection of evaluation dimensions for the survey. Survey questions were gathered from existing health information technology satisfaction surveys that reflected individual evaluation concepts, such as efficiency or benefits. Decisions about data-gathering methods (e.g., item selection) were made based on reviews of literature and surveys of clinician satisfaction with health information technology and expert input. Preliminary instrument validation was accomplished using qualitative and statistical analysis of five repeated sets of responses from clinicians at the pilot site and field administrations repeated twice at electronic health record implementation and paper-based comparison sites and by analyzing convergent evidence from observations and interviews. Reliability was assessed on one sample: 30 graduate nursing students at the single pilot site. Validity was assessed on three separate samples: (1) graduate nursing students (n = 30), (2) field test at a site with electronic health record (n = 39 participants), and (3) field test at a paper-based site (n = 17). The implementation and comparison sites are Program of All-Inclusive Care for the Elderly that provide managed day care for frail elderly. Survey responses were assessed for test-retest reliability, internal consistency, and content and construct validity. The instrument design enables its administration before and after electronic health record implementation. Work to date suggests the instrument is reliable and valid; it is offered to electronic health record evaluators for further testing and application.
开发并验证了一种新的调查工具，用于衡量临床医生（护士）对电子健康记录对临床流程影响的满意度。基于健康信息技术参考的评估框架指导了该调查评估维度的选择。调查问题取自现有的健康信息技术满意度调查，这些调查反映了诸如效率或效益等个体评估概念。关于数据收集方法（如项目选择）的决策是基于文献综述、临床医生对健康信息技术满意度的调查以及专家意见做出的。通过对试点站点和现场管理中临床医生的五组重复回复进行定性和统计分析来完成初步工具验证，这些回复在电子健康记录实施站点和纸质比较站点重复进行了两次，同时通过分析观察和访谈的收敛证据来完成。在一个样本上评估了信度：单个试点站点的30名护理学研究生。在三个独立样本上评估了效度：（1）护理学研究生（n = 30），（2）电子健康记录站点的现场测试（n = 39名参与者），以及（3）纸质站点的现场测试（n = 17）。实施站点和比较站点是为体弱老年人提供管理式日托服务的老年人综合护理项目。对调查回复进行了重测信度、内部一致性以及内容和结构效度评估。该工具设计使其能够在电子健康记录实施之前和之后进行管理。迄今为止的工作表明该工具可靠且有效；现提供给电子健康记录评估人员进行进一步测试和应用。
