Effect of work complexity & individual differences on nursing IT utilization
Various healthcare IT systems have been developed to reduce medication errors. Although these systems can help to improve patient safety and reduce adverse medical events, new problems are also generated with their utilizations. One key problem during IT implementation is the change of working process. Although many of these changes are recorded in different industries, very limited studies discuss the effects of working process features on IT implementation results. Especially in the healthcare IT implementation area, there are few researchers comprehensively studying how the design or features of working process may affect IT utilization. Along the medication administration process, the majority of healthcare IT related studies focus on earlier stages like drug ordering, transcribing, and dispensing, and more researches are needed to focus on administration and monitoring stages. Considering the medication administration and monitoring work in inpatient department is mostly completed by nurses, in this study, the computerized medication administration system for nurses is the targeted healthcare IT system, and the nursing work process in inpatient departments is the target work environment. Research questions in this study include: (1) how to model the work process of nursing work and study its effects on nursing IT utilization, (2) how to model the user cognition process after implementation when the IT system use is mandatory, and (3) what measures of individual differences of the nurses should be considered as factors affecting the nursing IT utilization. The nursing work complexity is firstly proposed in this study by combining information from sociotechnical nursing work system, detailed nursing work contents and healthcare working features. The nursing work complexity construct not only can represent the features of nursing work process, but also have better individual sensitivity than the work process. In this study, the nursing IT utilization is defined as continued use of IT system during and after IT implementation. The first stage is the period during IT implementation where Technology Acceptance Model related classic models can be directly applied. The second stage is the period long time after IT implementation where a new model is proposed based on IS continuance theory. In both IT utilization stages, the effects of nursing work complexity on IT satisfaction are studied and compared. Also, effects of some individual differences of nurses on IT utilization are studied in these two stages including gender, age, IT-experience, perceived innovative of IT system, shift, practice, nursing work experience, and emotional intelligence. Data are collected both during the IT implementation and long time after. The results show that nursing work complexity can be measured using the proposed list of items in this study. The effects of nursing work complexity on IT satisfaction are significant both during and long time after IT implementation. But during IT implementation, perceived work performance is one significant mediator between nursing work complexity and IT satisfaction. One IT continuance model is proposed and validated to model the cognitive process of users for continued use of IT system. Nursing work complexity and emotional intelligence are proved to have some types of direct effects on this IT continuance model. For the simple variables, practice is proved to have significant effects on nursing attitudes towards the IT system during implementation, and age and position of nurses are proved to be significant moderators towards the IT continued use.
Duffy, Purdue University.
Information Technology|Industrial engineering|Nursing
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