The Effectiveness of Electronic Health Record with Standardized Nursing Languages for Communicating Patient Status Related to a Clinical Event

Persistent Link:
http://hdl.handle.net/10150/195397
Title:
The Effectiveness of Electronic Health Record with Standardized Nursing Languages for Communicating Patient Status Related to a Clinical Event
Author:
Carrington, Jane M
Issue Date:
2008
Publisher:
The University of Arizona.
Rights:
Copyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.
Abstract:
The purpose of this research was to explore nurses' perceptions of the effectiveness of nursing documentation of patient status during a clinical event when using electronic documentation with or without embedded standardized languages. The theoretical framework for this study was based on principles of information theory. This study was significant in two very important ways; first, in contrast to prior studies, the perceptions of nurses were focused on the documentation of a clinical event. Second, this study explored the nurses' opinions about the strengths and limitations of using structured languages (specifically, the North American Nursing Diagnosis Association (NANDA), the Nursing Intervention Classification (NIC), and the Nursing Outcomes Classification (NOC)) for telling the patient's story during a clinical event, as well as collecting nurses' suggestions for improving electronic documentation. Semi-structured interviews of 37 nurses were conducted in two acute care hospitals. Both hospitals used electronic documentation, but only one used embedded standardized nursing languages. Half the interviewees were asked questions from the perspective of the nurse documenting a clinical event; half were asked questions from the perspective of a nurse reviewing another nurse's documentation of a clinical event. Recorded interviews were transcribed, and the transcripts analyzed using qualitative content analysis. A panel of judges was used to establish reliability of the coding scheme. The results showed that nurses perceived aspects of three categories (usability, legibility, and communication) as strengths of the documentation system. Nurses perceived aspects of three categories (usability, communication, and workarounds) as limitations of the documentation system. Potential solutions to improve the documentation system were defined related to three categories (usability, communication, and collaboration). Usability was perceived by the nurses as a strength of the electronic documentation with embedded nursing languages. Usability of the electronic documentation system with nursing languages was also perceived as a limitation. Improving language usability was identified as a potential solution to improve the electronic documentation system with embedded nursing languages.
Type:
text; Electronic Dissertation
Keywords:
Electronic Health Record; Standardized Nursing Languages
Degree Name:
PhD
Degree Level:
doctoral
Degree Program:
Nursing; Graduate College
Degree Grantor:
University of Arizona
Committee Chair:
Effken, Judith A.

Full metadata record

DC FieldValue Language
dc.language.isoENen_US
dc.titleThe Effectiveness of Electronic Health Record with Standardized Nursing Languages for Communicating Patient Status Related to a Clinical Eventen_US
dc.creatorCarrington, Jane Men_US
dc.contributor.authorCarrington, Jane Men_US
dc.date.issued2008en_US
dc.publisherThe University of Arizona.en_US
dc.rightsCopyright © is held by the author. Digital access to this material is made possible by the University Libraries, University of Arizona. Further transmission, reproduction or presentation (such as public display or performance) of protected items is prohibited except with permission of the author.en_US
dc.description.abstractThe purpose of this research was to explore nurses' perceptions of the effectiveness of nursing documentation of patient status during a clinical event when using electronic documentation with or without embedded standardized languages. The theoretical framework for this study was based on principles of information theory. This study was significant in two very important ways; first, in contrast to prior studies, the perceptions of nurses were focused on the documentation of a clinical event. Second, this study explored the nurses' opinions about the strengths and limitations of using structured languages (specifically, the North American Nursing Diagnosis Association (NANDA), the Nursing Intervention Classification (NIC), and the Nursing Outcomes Classification (NOC)) for telling the patient's story during a clinical event, as well as collecting nurses' suggestions for improving electronic documentation. Semi-structured interviews of 37 nurses were conducted in two acute care hospitals. Both hospitals used electronic documentation, but only one used embedded standardized nursing languages. Half the interviewees were asked questions from the perspective of the nurse documenting a clinical event; half were asked questions from the perspective of a nurse reviewing another nurse's documentation of a clinical event. Recorded interviews were transcribed, and the transcripts analyzed using qualitative content analysis. A panel of judges was used to establish reliability of the coding scheme. The results showed that nurses perceived aspects of three categories (usability, legibility, and communication) as strengths of the documentation system. Nurses perceived aspects of three categories (usability, communication, and workarounds) as limitations of the documentation system. Potential solutions to improve the documentation system were defined related to three categories (usability, communication, and collaboration). Usability was perceived by the nurses as a strength of the electronic documentation with embedded nursing languages. Usability of the electronic documentation system with nursing languages was also perceived as a limitation. Improving language usability was identified as a potential solution to improve the electronic documentation system with embedded nursing languages.en_US
dc.typetexten_US
dc.typeElectronic Dissertationen_US
dc.subjectElectronic Health Recorden_US
dc.subjectStandardized Nursing Languagesen_US
thesis.degree.namePhDen_US
thesis.degree.leveldoctoralen_US
thesis.degree.disciplineNursingen_US
thesis.degree.disciplineGraduate Collegeen_US
thesis.degree.grantorUniversity of Arizonaen_US
dc.contributor.chairEffken, Judith A.en_US
dc.contributor.committeememberEffken, Judith A.en_US
dc.contributor.committeememberVerran, Joyce A.en_US
dc.contributor.committeememberMichaels, Cathleen L.en_US
dc.identifier.proquest2643en_US
dc.identifier.oclc659749638en_US
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