Lalley Cathy
Arizona State University, College of Nursing & Health Innovation, Phoenix, Arizona.
Nurs Adm Q. 2014 Jan-Mar;38(1):69-77. doi: 10.1097/NAQ.0000000000000015.
Nurse leaders are aware that nurses are finding ways to adapt health information technology to patient care activities. Previous literature has presented nurses' response to technology obstacles as a work-around, characterized as a negative behavior. Using narrative inquiry, this article examines 9 direct care nurses' interactions on a medical/surgical/telemetry unit. Specifically, nurses' encounters with technology obstacles will be addressed from a complexity science perspective. Four support staff including the clinical nurse manager, pharmacist, quality nurse, and project manager who is also a nurse were interviewed as part of data collection. Complexity science provides nurse leaders' insight into nurses' behavior where outcomes emerge from tensions in the environment through multidirectional and self-organizing interactions. Innovation was found when nurses responded to health information technology obstacles with self-organizing interactions, sensitivity to initial conditions, and multidirectionality. Their actions were also influenced by many sets of rules. Nurses self-organized with coworkers to find better ways to deliver care to patients when using technology. Opportunities exist for nurse leaders to facilitate interactions among nurses and other members of the organization to realize better use of health information technology that improves the patient experience.
护士领导者们意识到护士们正在寻找方法，使健康信息技术适应患者护理活动。以往的文献将护士对技术障碍的应对描述为一种变通方法，其特征是一种消极行为。本文采用叙事探究法，研究了9名在医疗/外科/遥测病房工作的直接护理护士的互动情况。具体而言，将从复杂性科学的角度探讨护士遇到的技术障碍。作为数据收集的一部分，采访了包括临床护士长、药剂师、质量护士以及身为护士的项目经理在内的4名支持人员。复杂性科学使护士领导者能够深入了解护士的行为，即结果是通过多向和自组织的互动，从环境中的各种矛盾中产生的。当护士通过自组织互动、对初始条件的敏感性和多向性来应对健康信息技术障碍时，就会产生创新。他们的行为也受到多套规则的影响。护士们与同事进行自组织，以便在使用技术时找到更好的方法为患者提供护理。护士领导者有机会促进护士与组织内其他成员之间的互动，以更好地利用健康信息技术，从而改善患者体验。
