Nurses' perceptions of how clinical information system implementation affects workflow and patient care

Area of Science:

• Health Informatics
• Nursing Practice
• Information Systems

Background:

• Limited evidence exists on the impact of clinical information system (CIS) implementation on nursing workflow and patient care.
• Institutions nationwide are implementing electronic health records (EHRs), necessitating guidance on effective adoption strategies.
• Understanding nurses' perceptions during CIS implementation is crucial for successful integration and improved patient outcomes.

Purpose of the Study:

• To compare nurses' perceptions of patient care processes and workflow before and after a comprehensive CIS implementation.
• To identify factors influencing nurses' experiences and satisfaction with the new clinical information system.
• To provide evidence-based recommendations for optimizing CIS implementation and training.

Main Methods:

• A quasi-experimental study design was employed at a rural referral hospital.
• The Information Systems Expectations and Experiences survey, comprising seven scales, was administered to nurses at three time points: pre-implementation, post-training, and post-implementation.
• Survey responses were analyzed to identify significant changes in perceptions and to explore correlations with nurse experience.

Main Results:

• A significant decrease in positive survey responses was observed for 8 items after training and 37 items after implementation.
• Nurses with prior EHR experience reported more positive perceptions compared to those with less experience.
• Nurses with more years of work experience tended to have less positive perceptions of the CIS.

Conclusions:

• Nurses' perceptions of CIS implementation can decline significantly post-training and post-implementation.
• Prior EHR experience positively influences nurses' perceptions, while extensive work experience may correlate with less positive views.
• Effective CIS implementation requires setting realistic expectations, continuous user assessment, tailored training, and adaptive support strategies for nurses.