The impact of computerization on nursing: an interview study of users and facilitators

When health care settings are computerized, nurses' jobs are affected. Hospitals must understand this important phenomenon in order to develop the best possible implementation strategies that consider the impact nurses may experience. The goals of this study were the following: 1) to explore the personal and job-related effects of computerization on nurses; 2) to determine the factors that helped these nurses cope during the computerization process; and 3) to derive recommendations that could assist hospitals implementing computerization in future. Twenty nurses were identified by their peers as knowledgeable informants for a research interview: 10 staff nurse users and 10 nurse educators or administrators serving as facilitators of the change. The confidential interviews were analyzed using a grounded theory approach with constant comparative analysis of the emerging categories. The investigators developed a visual model showing six themes that have the greatest effect on the nurses: 1) time frame, 2) choice of software, 3) communication, 4) the change process, 5) training, and 6) leadership. These themes were considered within a broad hospital context, in which budget, nurse involvement, policy practice issues, and other concurrent projects also influenced nursing. In addition, personal characteristics of each nurse affected how each nurse experienced the change to computerization. Recommendations from the respondents addressed a wide range of factors that may be useful to other hospitals planning to implement computerization in nursing.