• Patti Rager Zuzelo, Catherine Gettis, Amanda Whitekettle Hansell, and Linda Thomas.
• La Salle University, School of Nursing and Health Sciences, Philadelphia, Pennysylvania 19141, USA. Zuzelo@lasalle.edu
• Clin Nurse Spec. 2008 May 1; 22 (3): 132-40; quiz 141-2.

Purpose/ObjectiveThe purpose of this study was to describe the influence of technologies on registered nurses' (RNs) work. The study examined the characteristics of technologies that encourage or hinder their correct use and identified RNs' concerns when introduced to new or changed technologies.DesignFour focus group sessions were conducted to collect data describing nurses' concerns as they work with technologies during daily practice and make decisions as to how or how not to use technologies. Transcript content was thematically analyzed, and data were organized to reveal major themes, themes, and subthemes.SettingThe study was conducted at an urban healthcare network in a large northeastern city. Registered nurses employed at 2 institutions within the network, a general acute care hospital and a tertiary care medical center, participated in the group discussions.SamplePurposively selected RN participants (N = 31) provided direct care to patients on medical-surgical care units, including telemetry units. Participants had a minimum of 1 year of experience and were employed at least 20 hours weekly.MethodsFocus group discussions followed a preestablished query path and lasted approximately 90 minutes. Food served as an incentive for participation. Informed consent was obtained. Discussions were audiotape recorded. Discussion data were listed on flip charts during group interviews. The principal investigator served as the group moderator, and a clinical nurse specialist coinvestigator facilitated participation and took notes. Debriefing sessions followed each discussion.FindingsContent analysis revealed that technologies enhanced nursing practice by improving direct care processes, patient outcomes, and work environments. Working with inefficient systems of technology delivery, use, and repair created challenges for nurses and physically unfriendly equipment increased the burden of nurses' work. Nurses bypassed problems rather than proactively solving them, occasionally leading to safety breeches. Technologies led to changing nurse role expectations and altered healthcare team dynamics.ConclusionsTechnology-use systems require monitoring and regular evaluation. System gaps create problems that potentially increase error risk and contribute to nurse dissatisfaction.Implications For PracticeCertified nurse specialists may be more accustomed to considering and addressing the front-end needs of new and existing technologies, specifically, in introducing the technology into practice. Study findings suggest that gaps develop throughout the life of technology-use systems. Technologies and their use contexts should be regularly examined so that nurses are less inclined to commit work-arounds or breech established safety measures.

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