Journal List > J Korean Acad Nurs > v.45(4) > 1003091

Cho, Choi, Choi, Hyun, Park, Lee, Cho, and Hwang: Identifying Usability Level and Factors Affecting Electronic Nursing Record Systems: A Multi-institutional Time-motion Approach

Abstract

Purpose

The usability, user satisfaction, and impact of electronic nursing record (ENR) systems were investigated.

Methods

This mixed-method research was performed as a time-motion (TM) study and a survey which were carried out at six hospitals between August and November 2013. The TM study involved 108 nurses from medical, surgical, and intensive care units at each hospital, plus an additional 48 nurses who served as nonparticipating observers. In the survey, 1879 volunteer nurses completed the Impact of ENR Systems Scale, the System Usability Scale, and a global satisfaction scale. Qualitative and quantitative analyses were performed.

Results

The mean scores for the ENR impact, system usability, and satisfaction were 4.28 (out of 6), 58.62 (out of 100), and 74.31 (out of 100), respectively, and they differed significantly between hospitals (F=43.43, p<.001, F=53.08 and p<.001, and F=29.13 and p<.001, respectively). A workflow fragmentation assessment revealed different patterns of ENR system use among the included hospitals. Three user characteristics-educational background, practice period, and experience of using paper records-significantly affected the system usability and satisfaction scores.

Conclusion

The system quality varied widely among the ENR systems. The generally low-to-moderate levels of system usability and user satisfaction suggest many opportunities for improvement.

Figures and Tables

Figure 1

Research framework of clinical impact and usability of electronic nursing record systems.

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Figure 2

Comparisons the scores of impact of the system, system usability, and overall satisfaction.

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Figure 3

The 'timeline belt' visualization exhibiting nursing activity fragmentation of a medical nursing units.

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Table 1

Characteristics of Nurses Participated in the Self-reporting Questionnaire

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a, b, cGroup contrast by Tukey test; CI=Confidence interval; ENR=Electronic nursing records.

Table 2

Multiple Regression of Respondent's-characteristics-adjusted Impact of ENRs, Usability Score of ENR, and Overall Satisfaction on ENR

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ENR=Electronic nursing record.

Notes

This study was supported by the Hospital Nurses Association of Korean Nurses Association in 2013.

This study was also supported by a grant from Inha University in 2014 (No. 50463-01).

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