Identification of Factors Influencing the Adoption of Health Information Technology by Nurses Who Are Digitally Lagging: In-Depth Interview Study (Preprint)

Abstract

BACKGROUND The introduction of health information technology (HIT) has drastically changed health care organizations and the way health care professionals work. Some health care professionals have trouble coping efficiently with the demands of HIT and the personal and professional changes it requires. Lagging in digital knowledge and skills hampers health care professionals from adhering to professional standards regarding the use of HIT and may cause professional performance problems, especially in the older professional population. It is important to gain more insight into the reasons and motivations behind the technology issues experienced by these professionals, as well as to explore what could be done to solve them. OBJECTIVE Our primary research objective was to identify factors that influence the adoption of HIT in a sample of nurses who describe themselves as digitally lagging behind the majority of their colleagues in their workplaces. Furthermore, we aimed to formulate recommendations for practice and leadership on how to help and guide these nurses through ongoing digital transformations in their health care work settings. METHODS In a Dutch university medical center, 10 face-to-face semi-structured interviews were performed with registered nurses (RN). Ammenwerth’s FITT-framework (fit between the Individual, Task, and Technology) was used to guide the interview topic list and to formulate themes to explore. Thematic analysis was used to analyze the interview data. The FITT-framework was also used to further interpret and clarify the interview findings. RESULTS Analyses of the interview data uncovered 5 main categories and 12 subthemes. The main categories were: (1) experience with digital working, (2) perception and meaning, (3) barriers, (4) facilitators, and (5) future perspectives. All participants used electronic devices and digital systems, including the electronic health record. The latter was experienced by some as user-unfriendly, time-consuming, and not supportive in daily professional practice. Most of the interviewees described digital working as “no fun at all,” “working in a fake world,” “stressful,” and “annoying.” There was a lack of general digital knowledge and little or no formal basic digital training or education. A negative attitude toward computer use and a lack of digital skills contributed to feelings of increased incompetency and postponement or avoidance of the use of HIT, both privately and professionally. Learning conditions of digital training and education did not meet personal learning needs and learning styles. A positive impact was seen in the work environment when colleagues and nurse managers were aware and sensitive to the difficulties participants experienced in developing digital skills, and when there was continuous training on the job and peer support from digitally savvy colleagues. The availability of a digital play environment combined with learning on the job and support of knowledgeable peers was experienced as helpful and motivating by participants. CONCLUSIONS Nurses who are digitally lagging often have had insufficient and ineffective digital education. This leads to stress, frustration, feelings of incompetency, and postponement or avoidance of HIT use. A digital training approach tailored to the learning needs and styles of these nurses is needed, as well as an on-the-job training structure and adequate peer support. Hospital management and nurse leadership should be informed about the importance of the fit between technology, task, and the individual for adequate adoption of HIT.

Teknostress hos sykepleiere – ikke bare angst og fobi

“…Tilpasset brukerstøtte, involvering i planlegging og utforming av systemer samt opplaering, veiledning og støtte for å øke ferdigheter og kompetanse hos brukerne, er elementer som har vist seg å redusere teknostress (7). DeLeeuw og medarbeidere intervjuet sykepleiere som synes det var krevende å henge med på digitale endringer (13). De var villige til å laere og i økende grad innså de verdien av digitale redskaper, men opplevde at arbeid ved PC-en tok verdifull tid som de mente kunne vaert brukt hos pasienten.…”

“…Basert på samspillet mellom sykepleiere, oppgavene de utfører og teknologien de bruker, beskriver forfatterne en modell som viser at hensiktsmessig tilpasning mellom teknologi og jobbkontekst er basert på en treenighet mellom oppgave, menneske og teknologi. Forholdet mellom disse elementene indikerer grad av vellykket tilpasning (13). En studie ved en rehabiliteringsenhet ved overgang fra papirjournal til EPJ viste endret arbeidsflyt pga.…”

“…å lage klare rutiner for beskjedformidling. Teknologien får altså betydning gjennom den konteksten den brukes i og oppgavene som skal løses (13,24,25). Den enkelte får en opplevelse av om teknologien «samarbeider» eller ikke, f.eks.…”

“…Samspillet mellom menneske, oppgave og teknologi er beskrevet av flere forskere (13,14,15). En forståelse av dette komplekse samspillet kan bidra til årsaks-og tiltaksanalyse av situasjoner med teknostress.…”

Effect of Digitalization on Nursing Practices using the Lean Approach

“…In the field of health, digitalization is defined as medical applications provided through different digital technologies to support and improve the delivery and management of health care services (1). Digitalization changes health service delivery routines to a great extent (2). Nurses constitute the largest workforce in health service delivery and have an important role in achieving quality care outcomes (3).…”