Knowledge and attitudes of nurses in community health centres about electronic medical records

Abstract

Background: Nurses in primary healthcare record data for the monitoring and evaluation of diseases and services. Information and communications technology (ICT) can improve quality in healthcare by providing quality medical records. However, worldwide, the majority of health ICT projects have failed. Individual user acceptance is a crucial factor in successful ICT implementation.Objectives: The aim of this study is to explore nurses’ knowledge, attitudes and perceptions regarding ICT so as to inform the future implementation of electronic medical record (EMR) systems.Methods: A qualitative design was used. Semi-structured interviews were undertaken with nurses at three community health centres (CHCs) in the King Sabata Dalyindyebo Local Municipality. The interview guide was informed by the literature on user acceptance of ICT. Interviews were recorded and analysed using content analysis.Results: Many nurses knew about health ICT and articulated clearly the potential benefits of an EMR such as fewer errors, more complete records, easier reporting and access to information. They thought that an EMR system would solve the challenges they identified with the current paper-based record system, including duplication of data, misfiling, lack of a chronological patient record, excessive time in recording and reduced time for patient care. For personal ICT needs, approximately half used cellphone Internet-based services and computers.Conclusions: In this study, nurses identified many challenges with the current recording methods. They thought that an EMR should be installed at CHCs. Their knowledge about EMR, positive attitudes to ICT and personal use of ICT devices increase the likelihood of successful EMR implementation at CHCs.

Tablet computers for recording tuberculosis data at a community health centre in King Sabata Dalindyebo Local Municipality, Eastern Cape: a proof of concept report

“…They also wanted to extend the use of tablet computers to other areas of their work; consistent with their use of mobile technologies as part of everyday life. 23 The results were consistent with previous studies, in which point-of-care technology with portable computing devices was associated with ease of use and faster recording. 14 Data should be captured once at the point of care so that monitoring and evaluation processes are linked to clinical care.…”

“…A previous study had shown that nurses in King Sabata Dalindyebo Local Municipality had favourable attitudes to health information technology, and that many used smartphones. 23 Training of the nurses who worked mainly in tuberculosis care took approximately an hour before they were competent enough to use the application. They used two tablets for one week in December 2012 to record the tuberculosis symptoms of patients sent for tuberculosis screening.…”

Lest we forget, primary health care in Sub-Saharan Africa is nurse led. Is this reflected in the current health systems strengthening undertakings and initiatives?

“…12 , 13 There are at least 17 registers per community health centre (CHC) for recording the attendance of single events related to patient care, specific conditions or procedures such as births, tuberculosis, immunisations and patient consultations. 13 , 14 In each one, patients' demographic data have to be recorded leading to duplication which nurses perceived to be a waste of time. 14 Separation of data in different registers raises concerns related to continuity of care, stemming from the lack of a complete chronological record.…”

Reimplementing Telemedicine in the Eastern Cape

“…Typical primary healthcare services included preventative and curative services such as mother and child health, immunisations, preventative screening, family planning, and treatment of acute and chronic conditions in the community. Patients that could not be treated at the CHCs were referred to the second tier, that is the district hospitals, for more comprehensive care or the third tier, the tertiary hospitals, for specialist care (O'Mahony, Wright, Yogeswaran, & Govere, 2014;Cilliers & Flowerday, 2014). The province had 762 primary health care clinics, 60 community health care centres, 63 district hospitals, 11 regional hospitals, 12 specialised hospitals and one tertiary teaching hospital.…”