tion plan for the past three years,’ and you can show that to them in terms and schematics that they can understand... You can also reassure the patient that he or she is being given the right med, which fosters trust... The patient becomes engaged that way in [his or her] own health care information... The patient becomes a partnet in managing their own health care and taking some responsibility to make sure the data they see in the record is correctly associated with them.”

Limitations that hinder acceptance are:

Hospital

Not-for-profit, 528 beds in north Florida

Unit

Emergency department

IS Description

Electronic
documenting of
patient triage
and registration
information

Data

Interviews: 15
Observations: 12
Archival material : 20-page project proposal
description

Not-for-profit, 124 beds in middle Georgia

Ambulatory Electronic charting
care unit of pre-surgery
assessments

Interviews: 15

Observations: 22

Archival material: 115 pages of system documents

Post-anesthesia care unit

Electronic charting of post-surgery assessment

Interviews: 10

Observations: 13

Archival material: 14 pages of system documents

Federally In-hospital
funded, 478 beds stay
in middle Florida

Electronic documenting of medication administration

Interviews: 10

Observations: 10

Archival material: 320 pages of system documents

Table 1. Hospital characteristics.

 

• The inability to generate desired benefits when technologies, such as document and label printing and copying are not bundled with UA on a mobile workstation;

• Cumbersome IS designs that divert nurses’ attentions away from patients;

• Nurses’ lack of typing skills, lack of professional exposure and training to IS/IT, or general technology aversion; and

• The short battery life of power packs for mobile workstations.

 

RECOMMENDATIONS How can hospitals take full advantage of UA specifically to address the documentation and information acquisition components of nursing workflow? We propose seven action steps for attaining the full benefits of UA:

often force the user to pay more attention to the technology than the person seeking service [ 11], the patient in this case. Thus, the technology forces the user to engage more closely with the screen than the situation or certain aspects of the task, such as patient interaction. These actions are at the expense of the needed attention the patient expects, and which the nurse is accustomed to giving. Therefore, systems hardware and software must be designed to minimize the level of disengagement of the nurse from the patient in order to access or enter data during the work process. Also, nurses must be trained in how to orchestrate the technology in the work environment so as to maintain sufficient patient interaction to establish a bond and relieve anxieties that can impede the work process. Indeed, the technology design and subsequent user training is heavily contextually based. To truly add value, it must be designed to support how, when, and where nurses engage patients and document interventions.

1. Nursing education programs should integrate electronic patient-care-documentation-skills development into nursing curricula.

 

While some nursing programs include basic information systems/personal computing classes, many still do not, according to the nurses interviewed. The result is that, while nurses may be exposed to IS in other parts of their education, they may not be deeply familiar or comfortable with either wireless technology or information systems concepts. Nursing informatics is a separate discipline, but nurses trained in these programs typically do not perform daily clinical tasks. At the very least, nursing schools should partner with hospitals employing UA to expose student nurses to the technology and promote developing typing skills to expedite data entry.

Additionally, technology-mediated situations

2. Hospital management should use technology as a recruiting and retention tool.

 

One in five registered nurses plans to leave the profession, and 64% state they have inadequate time with patients [ 7]. These alarming statistics are likely to worsen as the pool of qualified nurses dwindles and those remaining are pressured still further. However, this study suggests that UA can address some of these factors, including job stress, working conditions, morale, patient-care time constraints, and paperwork burdens. It is possible that no other current technology may be as useful, at relatively low cost, for addressing such a wide range of nursing frustrations. Hospitals that implement UA—and provide ample, supportive training in its use—may find themselves more able to recruit and retain talented nurses, a significant advantage in a fiercely competitive labor market.