Staff perspectives on the usability of electronic patient records for planning and delivering dementia care in nursing homes: a multiple case study.
Assessment
Care plan
Dementia
Electronic health records
Electronic patient records
Nursing home
Journal
BMC medical informatics and decision making
ISSN: 1472-6947
Titre abrégé: BMC Med Inform Decis Mak
Pays: England
ID NLM: 101088682
Informations de publication
Date de publication:
13 07 2020
13 07 2020
Historique:
received:
30
04
2020
accepted:
22
06
2020
entrez:
15
7
2020
pubmed:
15
7
2020
medline:
17
12
2020
Statut:
epublish
Résumé
The electronic patient record (EPR) has been introduced into nursing homes in order to facilitate documentation practices such as assessment and care planning, which play an integral role in the provision of dementia care. However, little is known about how the EPR facilitates or hinders these practices from the end-user's perspective. Therefore, the objective of this qualitative study was to explore the usability issues associated with the EPR for assessment and care planning for people with dementia in nursing homes from a staff perspective. An exploratory, qualitative research design with a multiple case study approach was used. Contextual Inquiry was carried out with a variety of staff members (n = 21) who used the EPR in three nursing homes situated in Belgium, Czech Republic and Spain. Thematic analysis was used to code interview data, with codes then sorted into a priori components of the Health Information Technology Evaluation Framework: device, software functionality, organisational support. Two additional themes, structure and content, were also added. Staff provided numerous examples of the ways in which EPR systems are facilitating and hindering assessment and care planning under each component, particularly for people with dementia, who may have more complex needs in comparison to other residents. The way in which EPR systems were not customisable was a common theme across all three homes. A comparison of organisational policies and practices revealed the importance of training, system support, and access, which may be linked with the successful adoption of the EPR system in nursing homes. EPR systems introduced into the nursing home environment should be customisable and reflect best practice guidelines for dementia care, which may lead to improved outcomes and quality of life for people with dementia living in nursing homes. All levels of nursing home staff should be consulted during the development, implementation and evaluation of EPR systems as part of an iterative, user-centred design process.
Sections du résumé
BACKGROUND
The electronic patient record (EPR) has been introduced into nursing homes in order to facilitate documentation practices such as assessment and care planning, which play an integral role in the provision of dementia care. However, little is known about how the EPR facilitates or hinders these practices from the end-user's perspective. Therefore, the objective of this qualitative study was to explore the usability issues associated with the EPR for assessment and care planning for people with dementia in nursing homes from a staff perspective.
METHODS
An exploratory, qualitative research design with a multiple case study approach was used. Contextual Inquiry was carried out with a variety of staff members (n = 21) who used the EPR in three nursing homes situated in Belgium, Czech Republic and Spain. Thematic analysis was used to code interview data, with codes then sorted into a priori components of the Health Information Technology Evaluation Framework: device, software functionality, organisational support. Two additional themes, structure and content, were also added.
RESULTS
Staff provided numerous examples of the ways in which EPR systems are facilitating and hindering assessment and care planning under each component, particularly for people with dementia, who may have more complex needs in comparison to other residents. The way in which EPR systems were not customisable was a common theme across all three homes. A comparison of organisational policies and practices revealed the importance of training, system support, and access, which may be linked with the successful adoption of the EPR system in nursing homes.
CONCLUSIONS
EPR systems introduced into the nursing home environment should be customisable and reflect best practice guidelines for dementia care, which may lead to improved outcomes and quality of life for people with dementia living in nursing homes. All levels of nursing home staff should be consulted during the development, implementation and evaluation of EPR systems as part of an iterative, user-centred design process.
Identifiants
pubmed: 32660474
doi: 10.1186/s12911-020-01160-8
pii: 10.1186/s12911-020-01160-8
pmc: PMC7359585
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
159Subventions
Organisme : H2020 Marie Skłodowska-Curie Actions
ID : 676265
Pays : International
Références
BMJ. 2010 Sep 01;341:c4564
pubmed: 20813822
Stud Health Technol Inform. 2011;169:601-5
pubmed: 21893819
Gerontologist. 2006 Feb;46(1):128-33
pubmed: 16452293
Comput Inform Nurs. 2011 Mar;29(3):149-56
pubmed: 20975545
Geriatr Nurs. 2006 Jan-Feb;27(1):28-30
pubmed: 16528841
Inform Prim Care. 2014;21(2):78-83
pubmed: 24841408
Int J Med Inform. 2011 Feb;80(2):116-26
pubmed: 21242104
J Biomed Inform. 2011 Dec;44(6):1056-67
pubmed: 21867774
J Clin Transl Res. 2018 Aug 18;3(Suppl 3):424-430
pubmed: 30873491
J Psychiatr Res. 1975 Nov;12(3):189-98
pubmed: 1202204
Methods Inf Med. 2012;51(2):122-30
pubmed: 22311125
Appl Clin Inform. 2011 Oct 19;2(4):420-36
pubmed: 23616886
Md State Med J. 1965 Feb;14:61-5
pubmed: 14258950
Int J Med Inform. 2013 Sep;82(9):772-88
pubmed: 23770027
Contemp Nurse. 2013 Jun;44(2):156-69
pubmed: 23869500
Inform Health Soc Care. 2019 Sep;44(3):262-277
pubmed: 30125140
J Am Med Dir Assoc. 2000 May-Jun;1(3):114-6
pubmed: 12818023
J Healthc Qual. 2008 Mar-Apr;30(2):37-47
pubmed: 18411891
Comput Inform Nurs. 2007 Jul-Aug;25(4):189-97
pubmed: 17625399
Stud Health Technol Inform. 2011;169:965-9
pubmed: 21893889
Stud Health Technol Inform. 2015;216:406-9
pubmed: 26262081
Int J Med Inform. 2015 Aug;84(8):561-9
pubmed: 26004340
J Nurs Adm. 2015 May;45(5):239-42
pubmed: 25906130
Nurs Stand. 2016 Feb 24;30(26):51-7; quiz 60
pubmed: 26907149
J Appl Gerontol. 2017 Oct;36(10):1175-1196
pubmed: 26464335
Int J Med Inform. 2013 Nov;82(11):1068-74
pubmed: 24008175
J Am Geriatr Soc. 2007 Jul;55(7):1001-6
pubmed: 17608871
Open Med Inform J. 2010 Sep 15;4:202-5
pubmed: 21594005
Evid Based Nurs. 2018 Jan;21(1):7-8
pubmed: 29146764
Virtual Mentor. 2011 Mar 01;13(3):181-5
pubmed: 23127322
Methods Inf Med. 2007;46(3):332-43
pubmed: 17492120
BMC Med Inform Decis Mak. 2014 Jun 20;14:54
pubmed: 24947420
J Nurs Res. 2016 Dec;24(4):283-285
pubmed: 27846099
J Am Med Inform Assoc. 2015 Nov;22(6):1179-82
pubmed: 26049532
J Biomed Inform. 2004 Feb;37(1):56-76
pubmed: 15016386
P T. 2017 Sep;42(9):572-575
pubmed: 28890644
Int Disabil Stud. 1988;10(2):61-3
pubmed: 3403500
Ostomy Wound Manage. 2012 Mar;58(3):46-51
pubmed: 22391956
J Telemed Telecare. 2008;14(5):261-5
pubmed: 18633002
BMC Med Inform Decis Mak. 2016 Jan 25;16:8
pubmed: 26810606
Stud Health Technol Inform. 2007;127:231-45
pubmed: 17901615
J Gerontol Nurs. 2007 Feb;33(2):24-30
pubmed: 17310660
Clin Nurse Spec. 2013 Nov-Dec;27(6):283-5
pubmed: 24107749
Int J Med Inform. 2013 Sep;82(9):789-97
pubmed: 23786709
J Clin Nurs. 2012 Oct;21(19-20):2940-8
pubmed: 22827170