A quantitative analysis of the impact of a computerised information system on nurses' clinical practice using a realistic evaluation framework
A quantitative analysis of the impact of a computerised information system on nurses' clinical practice using a realistic evaluation framework
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DOI：
10.1016/j.ijmedinf.2009.08.008
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发表时间：
2009-12-01
影响因子：
4.9
通讯作者：
Watson, Roger
中科院分区：
文献类型：
--
作者：
Oroviogoicoechea, Cristina;Watson, Roger
目的：探讨护士对使用计算机化医院信息系统对临床实践的影响的看法。设计：基于 Pawson 和 Tilley 工作的现实评估设计已在研究的所有阶段使用。这是一种理论驱动的方法，重点评估研究什么有效、对谁有效以及在什么情况下有效。这些关系被构建为情境-机制-结果 (CMO) 配置。 测量：向西班牙一所大学医院住院部工作的所有护士分发了一份调查问卷 (n = 227)。使用SPSS 13.0对定量数据进行分析。使用描述性统计来总体概述护士的看法。推理分析，包括双变量和多变量方法（路径分析），用于对变量进行交叉制表，以寻找 CMO 关系。结果：护士 (n = 179) 参与了该研究（响应率为 78.8%）。对 IT 系统的总体满意度是积极的。与情境变量的比较表明，护理单位的情境对感知的影响比用户的特征更大。路径分析表明，单位背景变量的影响在于结果而不是机制。结论：研究结果着眼于用户和单位的细微变化，让我们深入了解专业文化和工作实践在 IT（信息技术）实施中的重要性。最近文献中提出的 IT 系统评估的社会技术方法似乎为 IT 评估研究提供了充分的理论基础。事实证明，现实评估是 IT 评估的适当方法。 (C) 2009 Elsevier Ireland Ltd. 保留所有权利。
Objective: To explore nurses' perceptions of the impact on clinical practice of the use of a computerised hospital information system.Design: A realistic evaluation design based on Pawson and Tilley's work has been used across all the phases of the study. This is a theory-driven approach and focuses evaluation on the study of what works, for whom and in what circumstances. These relationships are constructed as context-mechanisms-outcomes (CMO) configurations.Measurements: A questionnaire was distributed to all nurses working in in-patient units of a university hospital in Spain (n = 227). Quantitative data were analysed using SPSS 13.0. Descriptive statistics were used for an overall overview of nurses' perception. Inferential analysis, including both bivariate and multivariate methods (path analysis), was used for cross-tabulation of variables searching for CMO relationships.Results: Nurses (n = 179) participated in the study (78.8% response rate). Overall satisfaction with the IT system was positive. Comparisons with context variables show how nursing units' context had greater influence on perceptions than users' characteristics. Path analysis illustrated that the influence of unit context variables are on outcomes and not on mechanisms.Conclusion: Results from the study looking at subtle variations in users and units provide insight into how important professional culture and working practices could be in IT (information technology) implementation. The socio-technical approach on IT systems evaluation suggested in the recent literature appears to be an adequate theoretical underpinning for IT evaluation research. Realistic evaluation has proven to be an adequate method for IT evaluation. (C) 2009 Elsevier Ireland Ltd. All rights reserved.