Abstract
Implementing health information systems for enhancing patient care and management occurs worldwide. Discovering how nurses, as important system end-users, experience technology-reliant clinical practice involved focus groups (n = 25) and in-depth individual interviews with nurses (n = 4) and informatics staff (n = 3) in a major Taiwanese medical center. This qualitative study explores the unintended effects of these systems on nurses’ role and clinical practice. First, nurses’ additional role caring for computer devices supporting patient care involves highly-demanding invisible effort, especially when tackling system malfunctions affecting patients with urgent conditions. Second, nurses are resourceful in developing solutions to protect patients during unexpected technical malfunctions. Third, troubleshooting using telephone technical support as the first resort is problematic. It is argued that computerization requires nurses to care for co-clients: patients and computers. Managing technical malfunctions is an unintended consequence for nurses, reflecting the hidden work required by new technology.
Highlights
The discipline of health informatics arose during the 1970s [1] as an umbrella title covering medical, nursing, dental, and pharmacy informatics
The term “health information systems” (HIS) is used to mean “a set of components and procedures organized with the objective of generating information which will improve healthcare management decisions at all levels of the health system . . . integrate data collection, processing, reporting and use of the information necessary for improving health service effectiveness and efficiency through better management at all levels (p. 3)” [5]
Some participants perceived that their time spent on documentation had grown, which adversely affected the time available for patient care
Summary
The discipline of health informatics arose during the 1970s [1] as an umbrella title covering medical, nursing, dental, and pharmacy informatics. It is generally defined as computer sciences applied for collecting, managing, using, and sharing information to support healthcare delivery and promote health [2,3,4]. The term “health information systems” (HIS) is used to mean “a set of components and procedures organized with the objective of generating information which will improve healthcare management decisions at all levels of the health system . Integrate data collection, processing, reporting and use of the information necessary for improving health service effectiveness and efficiency through better management at all levels Investment to facilitate HIS use has tended to increase, in developing countries [6,12]
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