Entering a world of uncertainty: community nurses' engagement with information and communication technology.

Achieving adoption, use, and integration of information and communication technology by healthcare clinicians in the workplace is recognized as a challenge that requires a multifaceted approach. This article explores community health nurses' engagement with information and communication technology as part of a larger research project that investigated the delivery of self-management support to people with chronic obstructive pulmonary disease. Following a survey of computer skills, participants were provided with computer training to support use of the project information system. Changes in practice were explored using action research meetings and individual semistructured interviews. Results highlight three domains that affected nurses' acceptance, utilization, and integration of information and communication technology into practice; environmental issues; factors in building capacity, confidence, and trust in the technology; and developing competence. Nurses face individual and practice challenges when attempting to integrate new processes into work activities, and the use of participatory models to support adoption is recommended.