J Korean Acad Nurs.  2015 Aug;45(4):523-532. 10.4040/jkan.2015.45.4.523.

Identifying Usability Level and Factors Affecting Electronic Nursing Record Systems: A Multi-institutional Time-motion Approach

• Cho I
• Choi WJ
• Choi W
• Hyun M
• Park Y
• Lee Y
• Cho E
• Hwang O

• KMID: 2164393
• DOI: http://doi.org/10.4040/jkan.2015.45.4.523

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.

Keyword

Electronic health records; Nursing records; Time and motion studies; User-computer interface; Work satisfaction

MeSH Terms

Adult
Female
Humans
Male
*Nursing Records
Nursing Staff, Hospital/*psychology
Personal Satisfaction
Surveys and Questionnaires
*User-Computer Interface

Figure

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  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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