Adaskin E J, Hughes L, McMullan P, McLean M, McMorris D
St. Boniface General Hospital, Winnipeg, Manitoba, Canada.
Comput Nurs. 1994 May-Jun;12(3):141-8.
When health care settings are computerized, nurses' jobs are affected. Hospitals must understand this important phenomenon in order to develop the best possible implementation strategies that consider the impact nurses may experience. The goals of this study were the following: 1) to explore the personal and job-related effects of computerization on nurses; 2) to determine the factors that helped these nurses cope during the computerization process; and 3) to derive recommendations that could assist hospitals implementing computerization in future. Twenty nurses were identified by their peers as knowledgeable informants for a research interview: 10 staff nurse users and 10 nurse educators or administrators serving as facilitators of the change. The confidential interviews were analyzed using a grounded theory approach with constant comparative analysis of the emerging categories. The investigators developed a visual model showing six themes that have the greatest effect on the nurses: 1) time frame, 2) choice of software, 3) communication, 4) the change process, 5) training, and 6) leadership. These themes were considered within a broad hospital context, in which budget, nurse involvement, policy practice issues, and other concurrent projects also influenced nursing. In addition, personal characteristics of each nurse affected how each nurse experienced the change to computerization. Recommendations from the respondents addressed a wide range of factors that may be useful to other hospitals planning to implement computerization in nursing.
当医疗保健机构实现计算机化时，护士的工作会受到影响。医院必须了解这一重要现象，以便制定出尽可能完善的实施策略，同时考虑到护士可能受到的影响。本研究的目标如下：1）探讨计算机化对护士个人及与工作相关的影响；2）确定在计算机化过程中帮助这些护士应对的因素；3）得出有助于医院在未来实施计算机化的建议。20名护士被其同行认定为适合进行研究访谈的知识丰富的信息提供者：10名护士使用者和10名担任变革推动者的护士教育工作者或管理人员。采用扎根理论方法，对这些保密访谈进行持续比较分析，从而对访谈内容进行分析。研究人员绘制了一个可视化模型，展示了对护士影响最大的六个主题：1）时间框架，2）软件选择，3）沟通，4）变革过程，5）培训，6）领导力。这些主题是在医院这个大背景下进行考量的，在这个背景中，预算、护士参与度、政策实践问题以及其他并行项目也会对护理工作产生影响。此外，每位护士的个人特质也会影响其对计算机化变革的体验。受访者提出的建议涉及诸多因素，可能会对其他计划在护理工作中实施计算机化的医院有所帮助。
