Computers, informatics, nursing : CIN
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Adverse effects of EMR use have been rarely reported in South Korea. This study examined nurses' experiences with unintended adverse consequences associated with EMR implementation. The participants were 155 nurses using the EMR for patient care in three public hospitals. ⋯ The participants frequently experienced unintended adverse consequences that resulted from EMR use, and their experiences were organized into 11 subgroups under four dimensions of the unintended consequences instrument including the malfunction and inefficient design of EMR screens dimension (two groups), extra work from EMR implementation dimension (three groups), EMR incompatibility and changes in the prescription pattern dimension (three groups), and patient safety and EMR dependence (three groups). Successful implementation of EMRs is possible when unintended adverse consequences identified by the users are corrected and EMRs are tailored to user needs. Healthcare organizations should provide administrative support, timely technical remedy, and user training to increase user acceptance on a system.
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Nurses have experienced unintended consequences and workarounds associated with health information technology implementation. However, examination of this occurrence is rare. This study aimed to examine the unintended consequences and workarounds produced by the implementation of electronic medical record systems in clinical nursing practice. ⋯ The nursing examples of unintended consequences and workarounds were organized into four categories of unintended consequences. By presenting unintended consequences and workarounds together, this study enhances the understanding of the problems encountered in EMR implementation and the action of nurses. Nurses' needs should be considered as an important resource in developing, redesigning, or purchasing and implementing health information technology in healthcare settings.
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This study aimed to examine nurses' EMR workarounds in mental healthcare settings. Of the 52 nurses invited to participate in this study, 50 nurses (96.1%) completed the survey using the EMR nursing workaround instrument and open-ended questions. The data collected were analyzed using descriptive statistics and Pearson's correlation coefficients. ⋯ The workarounds associated with colleagues unfamiliar with EMR use included waiting for, filling in for, teaching, and assisting unskilled colleagues. This study identified the problems, consequences, and suggestions associated with EMR implementation for psychiatric patient care. This study added useful information for the administrative, technical, and clinical improvement of EMR implementation in mental healthcare practice.
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The objective of this study was to identify nurses' workarounds related to the use of electronic medical records in a tertiary teaching hospital. A total of 106 nurses (84.8%) using the electronic medical records completed 10-item questionnaires scored on a Likert scale and five open-ended questions with written responses. The numerical data were analyzed by descriptive statistics, and the written descriptions were categorized by meaning. ⋯ Although none of these identified workarounds were intended to be harmful, and certain workarounds were efficient for patient care and workflow, whether patient safety can be jeopardized by workarounds should be considered. This study contributes to the understanding of why and how workarounds occur in the hospital. It will be useful for achieving greater alignment between work contexts and the electronic medical record in the future.
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This study yielded a map of the alignment of American Association of Colleges of Nursing Graduate-Level Nursing Informatics Competencies with American Medical Informatics Association Health Informatics Core Competencies in an effort to understand graduate-level accreditation and certification opportunities in nursing informatics. Nursing Informatics Program Directors from the American Medical Informatics Association and a health informatics expert independently mapped the American Association of Colleges of Nursing competencies to the American Medical Informatics Association Health Informatics knowledge, skills, and attitudes. The Nursing Informatics Program Directors' map connected an average of 4.0 American Medical Informatics Association Core Competencies per American Association of Colleges of Nursing competency, whereas the health informatics expert's map connected an average of 5.0 American Medical Informatics Association Core Competencies per American Association of Colleges of Nursing competency. ⋯ These findings suggest that graduates of master's degree programs in nursing, especially those specializing in nursing informatics, will likely be prepared to sit for the proposed Advanced Health Informatics Certification in addition to the American Nurses Credentialing Center bachelor's-level Informatics Nursing Certification. This preliminary map sets the stage for further in-depth mapping of nursing informatics curricula with American Medical Informatics Association Core Competencies and will enable interprofessional conversations around nursing informatics specialty program accreditation, nursing workforce preparation, and nursing informatics advanced certification. Nursing informaticists should examine their need for credentials as key contributors who will address critical health informatics needs.