Centre for Quality and Patient Safety Research, Institute for Health Transformation, Deakin University School of Nursing and Midwifery, Melbourne, Victoria, Australia.
Monash Health Nursing and Midwifery Informatics, Melbourne, Victoria, Australia.
J Clin Nurs. 2023 Sep;32(17-18):6037-6060. doi: 10.1111/jocn.16730. Epub 2023 Apr 21.
To examine current literature for causal explanations on how, why and under what circumstances, implementation of a new hospital electronic medical record system or similar technology impacts nurses' work motivation, engagement, satisfaction or well-being.
Implementation of new technology, such as electronic medical record systems, affects nurses and their work, workflows and inter-personal interactions in healthcare settings. Multiple individual and organisational-level factors can affect technology adoption by nurses and may have negative consequences for nurses and patient safety.
Five-step realist review method and Realist And Meta-narrative Evidence Syntheses: Evolving Standards checklist was used to guide this review. Eight initial theories (programme theories) were used as the basis to explore, examine and refine literature from a range of sources.
Literature from five databases (APA PsycInfo, CINAHL, Embase, IEEE Xplore and MEDLINE Complete) and grey literature (from 1 January 2000 to 31 October 2021) were systematically searched and retrieved on 4 November 2021.
In all, 8980 records were screened at the title and abstract level, of which 1027 full texts were screened and 10 were included in the review. Seven studies assessed concepts in both pre- and post-technology implementation. Most common contexts related to knowledge, rationale and skills to use new technology. Mechanisms that impacted nurses or nursing care delivery included: nurses' involvement in technology implementation processes; nurses' perceptions, understanding and limitations of technology impact(s) on patient care delivery; social supports; skills; implementation attitude and hardware. Work satisfaction was the most frequently examined outcome. An analysis led to nine final programme theories (including two original, six revised and one new programme theory).
Nurses must be informed about the rationale for new technology and have the knowledge and skills for its use. Understanding nurses' work motivation and attitudes related to technology adoption in the workplace can support work engagement, satisfaction and well-being.
Complex contexts and mechanisms play a role in nurses' work motivation, engagement, satisfaction and well-being with the implementation of new technology into healthcare settings.
Nurses, their work and workflows are all influenced by the implementation of new technologies (such as electronic medical records), which in turn has consequences for patient safety and quality of care.
No patient or public contribution.
CRD42020131875 (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=131875).
考察当前文献中关于新医院电子病历系统或类似技术如何、为何以及在何种情况下影响护士工作动机、参与度、满意度或幸福感的因果解释。
新技术的实施，如电子病历系统，会影响护士及其在医疗环境中的工作、工作流程和人际互动。多个个人和组织层面的因素会影响护士对技术的采用，并可能对护士和患者安全产生负面影响。
采用五步现实主义审查方法和现实主义与元叙述证据综合：不断发展的标准清单，以指导本次审查。最初使用了 8 个理论（方案理论）作为基础，从各种来源探索、检查和完善文献。
文献来自五个数据库（APA PsycInfo、CINAHL、Embase、IEEE Xplore 和 MEDLINE Complete）和灰色文献（2000 年 1 月 1 日至 2021 年 10 月 31 日），于 2021 年 11 月 4 日系统检索并检索到 8980 条记录。
在标题和摘要层面共筛选出 8980 条记录，其中 1027 篇全文被筛选，10 篇被纳入审查。7 项研究评估了技术实施前后的概念。最常见的背景与使用新技术的知识、原理和技能有关。影响护士或护理服务提供的机制包括：护士参与技术实施过程；护士对技术对患者护理服务提供的影响的看法、理解和局限性；社会支持；技能；实施态度和硬件。工作满意度是最常被检查的结果。分析导致了 9 个最终的方案理论（包括两个原始的、六个修订的和一个新的方案理论）。
必须向护士告知新技术的原理，并使其具备使用新技术的知识和技能。了解护士在工作场所采用技术的工作动机和态度，可以支持工作参与度、满意度和幸福感。
复杂的背景和机制在护士的工作动机、参与度、满意度和幸福感与新技术在医疗环境中的实施有关。
新的技术（如电子病历）的实施影响护士、他们的工作和工作流程，这反过来又对患者安全和护理质量产生影响。
无患者或公众贡献。
PROSPERO 注册号：CRD42020131875（https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=131875）。
