The role of organizational context and individual nurse characteristics in explaining variation in use of information technologies in evidence based practice

Abstract

BackgroundThere is growing awareness of the role of information technology in evidence-based practice. The purpose of this study was to investigate the role of organizational context and nurse characteristics in explaining variation in nurses’ use of personal digital assistants (PDAs) and mobile Tablet PCs for accessing evidence-based information. The Promoting Action on Research Implementation in Health Services (PARIHS) model provided the framework for studying the impact of providing nurses with PDA-supported, evidence-based practice resources, and for studying the organizational, technological, and human resource variables that impact nurses’ use patterns.MethodsA survey design was used, involving baseline and follow-up questionnaires. The setting included 24 organizations representing three sectors: hospitals, long-term care (LTC) facilities, and community organizations (home care and public health). The sample consisted of 710 participants (response rate 58%) at Time 1, and 469 for whom both Time 1 and Time 2 follow-up data were obtained (response rate 66%). A hierarchical regression model (HLM) was used to evaluate the effect of predictors from all levels simultaneously.ResultsThe Chi square result indicated PDA users reported using their device more frequently than Tablet PC users (p = 0.001). Frequency of device use was explained by ‘breadth of device functions’ and PDA versus Tablet PC. Frequency of Best Practice Guideline use was explained by ‘willingness to implement research,’ ‘structural and electronic resources,’ ‘organizational slack time,’ ‘breadth of device functions’ (positive effects), and ‘slack staff’ (negative effect). Frequency of Nursing Plus database use was explained by ‘culture,’ ‘structural and electronic resources,’ and ‘breadth of device functions’ (positive effects), and ‘slack staff’ (negative). ‘Organizational culture’ (positive), ‘breadth of device functions’ (positive), and ‘slack staff ‘(negative) were associated with frequency of Lexi/PEPID drug dictionary use.ConclusionAccess to PDAs and Tablet PCs supported nurses’ self-reported use of information resources. Several of the organizational context variables and one individual nurse variable explained variation in the frequency of information resource use.

Assessing and Changing Organizational Social Contexts for Effective Mental Health Services

“…In turn, the relationship between clinicians' intentions and their behaviors is moderated by the organizational barriers. The dual effect of culture and climate on intentions and barriers parallels research on innovation implementation and explains the influence of culture and climate on the adoption, implementation, and sustainment of EBTs and other innovations that has been established in many studies (1,4,9,14,18,21,29,55,56,64,75,112). Evidence has also shown that organizational culture impacts other employee behaviors (e.g., turnover) directly and indirectly through its effects on organizational climate (3,51,111).…”

Organizational and Individual Determinants of Evidence Use by Managers in Public Human Service Organizations

“…Scholarly attention to this model has informed an empirical literature on the questions of practitioner evidence use in social work and allied human service settings as well as strategies to support practitioner evidence use. Research in this area has explored the following: methods for locating external research and internal agency information (Thorsteinsson & Sveinsdottir, 2012); practitioner attitudes about evidence use and EBP (Aarons, Cafri, Lugo, & Sawitzky, 2012); use of technology to support research retrieval and use (Doran et al, 2012); use of research evidence for practice improvements ; and practitioner engagement in conducting agency-based research (Epstein, 2010). In addition, the identification of leadership and organizational cultural factors that promote practitioner involvement in evidence-informed activities has received increased attention .…”

“…As noted in Table 1, research has found that locating, appraising, and integrating evidence into practice requires time and training, neither of which may be available to practitioners unless such undertakings receive support (Doran et al, 2012;Gray et al, 2013). Existing research has clearly identified the importance of external factors that incentivize or require evidence use, including funding, policy dicta, and institutional expectations (Aarons et al, 2011;Moynihan & Lavertu, 2012).…”

“…Practitioners may be more likely to engage in evidence use in organizational settings characterized by a culture of learning, where evidence use is mandated or incentivized or where there exist cross-agency learning networks (Moynihan & Lavertu, 2012;Palinkas et al, 2011). Practitioners are also likely to use evidence if they are given time to explore research, discretion Downloaded by [Portland State University] at 11:59 18 September 2015 and training to engage with diverse types of evidence, and access to external and internal evidence (Doran et al, 2012;Gray, Joy, Plath, & Webb, 2013). These studies imply that managerial evidence use requires dedicated resources and organizational commitment to be sustained effectively (Austin, Dal Santo, & Lee, 2012).…”

Mobile technology: streamlining practice and improving care

“…Opportunities are diverse and include emails, texts, telephone advice, electronic records, web-based information and discussion boards, online appointment booking, virtual wards and services, remote monitoring and advice, and 'hub and spoke' services or consultations using videoteleconferencing. Nurses have described having access to handheld personal digital assistants (PDAs) and tablet computers as influential to the way in which they use information resources (Doran et al, 2012). Benefits have been demonstrated by Kiel and Resick (2013) who report the development of a virtual nurses' station using Blackboard technology to provide an area for nurses to exchange information, access necessary resources and print patient health-care information.…”