Filipova Anna A
Department of Public Administration, University of Wisconsin Oshkosh, Oshkosh, WI 54901-8655, USA.
Comput Inform Nurs. 2013 Jul;31(7):305-18. doi: 10.1097/NXN.0b013e318295e40e.
The purpose of this study was to determine the levels of automation for 21 clinical functions and the benefits and barriers to electronic health records use in skilled nursing facilities in one of the Midwestern states in the US. A cross-sectional design was implemented. Data were collected from nursing home administrators using a mail and online survey approach. A total of 156 usable questionnaires of 397 distributed were returned, for a 39.30% response rate. While many facilities reported fully automated Minimum Data Set assessments, licensed nurse clinical notes, and care plans, there remained a predominant reliance on paper for functions, such as diagnostic tests and consults. Although many facilities had advanced toward using automation to produce quality reports, they were lagging behind in the use of automated clinical decision support and summary reports. The top two barriers included the amount of capital needed and the cost for hardware and infrastructure. Facilities with paper records were more likely to identify those barriers for functions, such as clinical notes and assessments. The top three benefits were quality patient care monitoring, management control of performance, and anywhere/anytime easier access to clinical data. The study concludes with recommendations to nursing home leaders and other stakeholders.
本研究的目的是确定美国中西部某州熟练护理机构中21项临床功能的自动化水平，以及电子健康记录使用的益处和障碍。采用了横断面设计。通过邮件和在线调查的方式从养老院管理人员那里收集数据。在分发的397份问卷中，共收回156份可用问卷，回复率为39.30%。虽然许多机构报告说最小数据集评估、执业护士临床记录和护理计划已完全自动化，但在诊断测试和会诊等功能方面，仍然主要依赖纸质记录。尽管许多机构在利用自动化生成质量报告方面取得了进展，但在使用自动化临床决策支持和总结报告方面仍滞后。前两大障碍包括所需资金量以及硬件和基础设施成本。有纸质记录的机构更有可能指出临床记录和评估等功能方面的那些障碍。三大益处是高质量患者护理监测、绩效的管理控制以及随时随地更便捷地获取临床数据。该研究最后向养老院领导和其他利益相关者提出了建议。
