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移动设备上使用电子健康记录和客户信息系统的体验以及与实用护士节省工作时间相关的因素:横断面研究。

Experiences of Electronic Health Records' and Client Information Systems' Use on a Mobile Device and Factors Associated With Work Time Savings Among Practical Nurses: Cross-Sectional Study.

机构信息

Health and Social Service System Research, Finnish Institute for Health and Welfare, Helsinki, Finland.

Faculty of Social Sciences and Business Studies, University of Eastern Finland, Kuopio, Finland.

出版信息

J Med Internet Res. 2024 May 29;26:e46954. doi: 10.2196/46954.

Abstract

BACKGROUND

The transmission of clinical information in nursing predominantly occurs through digital solutions, such as computers and mobile devices, in today's era. Various technological systems, including electronic health records (EHRs) and client information systems (CISs), can be seamlessly integrated with mobile devices. The use of mobile devices is anticipated to rise, particularly as long-term care is increasingly delivered in environments such as clients' homes, where computers are not readily accessible. However, there is a growing need for more user-centered data to ensure that mobile devices effectively support practical nurses in their daily activities.

OBJECTIVE

This study aims to analyze practical nurses' experiences of using EHRs or CISs on a mobile device in their daily practice. In addition, it aims to examine the factors associated with work time savings when using EHRs/CISs on a mobile device.

METHODS

A cross-sectional study using an electronic survey was conducted in spring 2022. A total of 3866 practical nurses participated in the survey based on self-assessment. The sample was limited to practical nurses who used EHRs or CISs on a mobile device and worked in home care or service housing within the social welfare or health care sector (n=1014). Logistic regression analysis was used to explore the factors associated with work time savings.

RESULTS

The likelihood of perceiving work time savings was higher among more experienced EHR/CIS users compared with those with less experience (odds ratio [OR] 1.59, 95% CI 1.30-1.94). Participants with 0-5 years of work experience were more likely to experience work time savings compared with those who had worked 21 years or more (OR 2.41, 95% CI 1.43-4.07). Practical nurses in home care were also more likely to experience work time savings compared with those working in service housing (OR 1.95, 95% CI 1.23-3.07). A lower grade given for EHRs/CISs was associated with a reduced likelihood of experiencing work time savings (OR 0.76, 95% CI 0.66-0.89). Participants who documented client data in a public area were more likely to experience work time savings compared with those who did so in the nurses' office (OR 2.33, 95% CI 1.27-4.25). Practical nurses who found documentation of client data on a mobile device easy (OR 3.05, 95% CI 2.14-4.34) were more likely to experience work time savings compared with those who did not. Similarly, participants who believed that documentation of client data on a mobile device reduced the need to memorize things (OR 4.10, 95% CI 2.80-6.00) were more likely to experience work time savings compared with those who did not.

CONCLUSIONS

To enhance the proportion of practical nurses experiencing work time savings, we recommend that organizations offer comprehensive orientation and regular education sessions tailored for mobile device users who have less experience using EHRs or CISs and find mobile devices less intuitive to use.

摘要

背景

在当今时代,临床信息在护理中的传输主要通过计算机和移动设备等数字解决方案进行。各种技术系统,包括电子健康记录 (EHR) 和客户信息系统 (CIS),可以与移动设备无缝集成。预计移动设备的使用将会增加,特别是随着长期护理越来越多地在客户家中等环境中提供,而这些环境中通常无法使用计算机。然而,越来越需要更多以用户为中心的数据,以确保移动设备能够有效地支持实际护士的日常活动。

目的

本研究旨在分析实际护士在日常实践中使用移动设备上的 EHR 或 CIS 的体验。此外,还旨在研究与使用移动设备上的 EHR/CIS 节省工作时间相关的因素。

方法

2022 年春季进行了一项使用电子调查的横断面研究。共有 3866 名实际护士根据自我评估参加了调查。样本仅限于在社会福利或医疗保健部门的家庭护理或服务住房中使用移动设备的 EHR 或 CIS 并从事工作的实际护士(n=1014)。使用逻辑回归分析探讨与节省工作时间相关的因素。

结果

与经验较少的 EHR/CIS 用户相比,经验更丰富的 EHR/CIS 用户更有可能感知到工作时间的节省(优势比 [OR] 1.59,95%置信区间 [CI] 1.30-1.94)。与工作 21 年或以上的人相比,拥有 0-5 年工作经验的参与者更有可能节省工作时间(OR 2.41,95%CI 1.43-4.07)。在家庭护理工作的实际护士也比在服务住房工作的实际护士更有可能节省工作时间(OR 1.95,95%CI 1.23-3.07)。EHR/CIS 的评分较低与节省工作时间的可能性降低相关(OR 0.76,95%CI 0.66-0.89)。与在护士办公室记录客户数据的参与者相比,在公共区域记录客户数据的参与者更有可能节省工作时间(OR 2.33,95%CI 1.27-4.25)。与认为在移动设备上记录客户数据很容易的参与者相比(OR 3.05,95%CI 2.14-4.34),更有可能节省工作时间。同样,与不认为在移动设备上记录客户数据可以减少记忆需求的参与者相比(OR 4.10,95%CI 2.80-6.00),更有可能节省工作时间。

结论

为了提高实际护士中节省工作时间的比例,我们建议组织为经验较少且使用 EHR 或 CIS 以及发现移动设备不直观的移动设备用户提供全面的定向和定期教育课程。

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