REVIEW
Methods used to examine technology in relation to the quality of nursing work in acute care: A systematic integrative review
Bernice Redley PhD, RN, BN Hons,
Tracy Douglas RN, BN Hons,
Mari Botti PhD, DipN, BA Melb,
Corresponding Author
Bernice Redley PhD, RN, BN Hons
Associate Professor
Centre for Quality and Patient Safety Research - Monash Health Partnership, School of Nursing and Midwifery, Deakin University, Burwood, Vic., Australia
Correspondence
Bernice Redley, Centre for Quality and Patient Safety Research - Monash Health Partnership, School of Nursing and Midwifery, Deakin University, Burwood Highway, Burwood, Vic., Australia.
Email: [email protected]
Search for more papers by this authorTracy Douglas RN, BN Hons
Research Assistant
School of Nursing and Midwifery, Deakin University, Burwood, Vic., Australia
Search for more papers by this authorMari Botti PhD, DipN, BA Melb
Professor
Centre for Quality and Patient Safety Research – Epworth Healthcare Partnership, School of Nursing and Midwifery, Deakin University, Burwood, Vic., Australia
Search for more papers by this authorBernice Redley PhD, RN, BN Hons,
Tracy Douglas RN, BN Hons,
Mari Botti PhD, DipN, BA Melb,
Corresponding Author
Bernice Redley PhD, RN, BN Hons
Associate Professor
Centre for Quality and Patient Safety Research - Monash Health Partnership, School of Nursing and Midwifery, Deakin University, Burwood, Vic., Australia
Correspondence
Bernice Redley, Centre for Quality and Patient Safety Research - Monash Health Partnership, School of Nursing and Midwifery, Deakin University, Burwood Highway, Burwood, Vic., Australia.
Email: [email protected]
Search for more papers by this authorTracy Douglas RN, BN Hons
Research Assistant
School of Nursing and Midwifery, Deakin University, Burwood, Vic., Australia
Search for more papers by this authorMari Botti PhD, DipN, BA Melb
Professor
Centre for Quality and Patient Safety Research – Epworth Healthcare Partnership, School of Nursing and Midwifery, Deakin University, Burwood, Vic., Australia
Search for more papers by this authorFunding information
This research was in-part funded by a National Health and Medical Research Centre (NHMRC) translating research into practice (TRIP) fellowship for the primary author.
Abstract
Aims and objectives
To systematically locate, assess and synthesise research to describe methods used to examine technology in relation to the quality of nursing work in acute care. Specific objectives were to (a) describe the types of nursing work examined; (b) describe methods used to examine technology in nursing work; (c) identify outcomes used to evaluate technology in relation to the quality of nursing work; and (d) make recommendations for future research.
Background
New technologies can offer numerous benefits to nurses; however, it is challenging to evaluate health information technologies in relation to the quality of nurses' complex day-to-day work.
Design
A systematic integrative review using a five-step process.
Methods
Five databases were searched using search terms “nurs*,” “workload,” “task,” “time.” Data screening, extraction and interpretation were conducted independently by at least two authors and agreement verified by discussion. Data extraction followed PRISMA guidelines.
Results
Of the 41 studies included, most (87.8%, n = 36) examined physical dimensions of nursing work; 31.7% (n = 13) organisational dimensions; 17.1% (n = 8) cognitive dimensions; and only 12.2% (n = 5) emotional dimensions. More than half (58.5%, n = 24) examined only one dimension; one captured all four dimensions. Most frequently examined technologies were electronic medical/health records (36.5%) and electronic medication management (19.5%). Direct observation (58.8%, n = 28) and multiple methods (19.5%, n = 8) were the most common methods; nurse tasks, frequency, duration and time distribution were variables most often measured.
Conclusions
Examinations of technology in nursing work often failed to capture the multiple dimensions of this work nor did they recognise the complexity of day-to-day nursing work in acute care. There is a paucity of literature to inform how and what technology should be measured in relation to the quality of nursing care.
Relevance to clinical practice
The outcomes inform useful research methods to comprehensively examine technology to enhance the quality of complex nursing work.
CONFLICT OF INTEREST
The authors have no conflict of interest to declare.
Supporting Information
| Filename | Description |
|---|---|
| jocn15213-sup-0001-TableS1.docxWord document, 16.2 KB | |
| jocn15213-sup-0002-TableS2.docxWord document, 38.9 KB | |
| jocn15213-sup-0003-TableS3.docxWord document, 13.3 KB | |
| jocn15213-sup-0004-TableS4.docxWord document, 75.3 KB | |
| jocn15213-sup-0005-TableS5.docxWord document, 74.9 KB | |
| jocn15213-sup-0006-TableS6.docxWord document, 14.9 KB | |
| jocn15213-sup-0007-TableS7.docxWord document, 22.9 KB | |
| jocn15213-sup-0008-TableS8.docxWord document, 35 KB | |
| jocn15213-sup-0009-AppendixS1.docWord document, 64 KB |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
REFERENCES
- Aiken, L. H., Sloane, D. M., Bruyneel, L., Van den Heede, K., Sermeus, W. & RN4CAST Consortium (2013). Nurses' reports of working conditions and hospital quality of care in 12 countries in Europe. International Journal of Nursing Studies, 50(2), 143–153. https://doi.org/10.1016/j.ijnurstu.2012.11.009
- Ampt, A., & Westbrook, J. I. (2007). Measuring nurses' time in medication related tasks prior to the implementation of an electronic medication management system. Studies in Health Technology and Informatics, 130, 157–167.
- Asaro, P. V., & Boxerman, S. B. (2008). Effects of computerized provider order entry and nursing documentation on workflow. Academic Emergency Medicine, 15(10), 908–915. https://doi.org/10.1111/j.1553-2712.2008.00235.x
- Ballermann, M. A., Shaw, N. T., Arbeau, K. J., Mayes, D. C., & Noel Gibney, R. T. (2010). Impact of a critical care clinical information system on interruption rates during intensive care nurse and physician documentation tasks. Studies in Health Technology and Informatics, 160, 274–278. https://doi.org/10.3233/978-1-60750-588-4-274
- Banner, L., & Olney, C. M. (2009). Automated clinical documentation: Does it allow nurses more time for patient care? Computers, Informatics, Nursing, 27(2), 75–81. https://doi.org/10.1097/NCN.0b013e318197287d
- Bennett, J., Harper-Femson, L. A., Tone, J., & Rajmohamed, Y. (2006). Improving medication administration systems: An evaluation study. Canadian Nurse, 102(8), 35–39.
- Berg, G. M., LoCurto, J., & Lippoldt, D. (2017). Stages of adoption concern and technology acceptance in a critical care nursing unit. The Journal of Nursing Administration, 47(9), 441–447. https://doi.org/10.1097/NNA.0000000000000511
- Bergey, M. R., Goldsack, J. C., & Robinson, E. J. (2019). Invisible work and changing roles: Health information technology implementation and reorganization of work practices for the inpatient nursing team. Social Science and Medicine, 235, 112387. https://doi.org/10.1016/j.socscimed.2019.112387
- Bhandari, G., Hassanein, K., & Deaves, R. (2008). Debiasing investors with decision support systems: An experimental investigation. Decision Support Systems, 46(1), 399–410. https://doi.org/10.1016/j.dss.2008.07.010
- Blay, N., Duffield, C. M., Gallagher, R., & Roche, M. (2014). Methodological integrative review of the work sampling technique used in nursing workload research. Journal of Advanced Nursing, 70(11), 2434–2449. https://doi.org/10.1111/jan.12466
- Bosman, R. J., Rood, E., Oudemans-van Straaten, H. M., Van der Spoel, J. I., Wester, J. P., & Zandstra, D. F. (2003). Intensive care information system reduces documentation time of the nurses after cardiothoracic surgery. Intensive Care Medicine, 29(1), 83–90. https://doi.org/10.1007/s00134-002-1542-9
- Braithwaite, J., Churruca, K., Long, J. C., Ellis, L. A., & Herkes, J. (2018). When complexity science meets implementation science: A theoretical and empirical analysis of systems change. BMC Medicine, 16(1), 63. https://doi.org/10.1186/s12916-018-1057-z
- Chung, E.-J., Kim, H.-J., Park, K.-H., Song, Y.-A., Lee, B.-N., Lee, M.-J., … Lee, H.-S. (2006). An evaluation of the time for nursing activity in a hospital using a full electronic medical record system (EMR). Studies in Health Technology and Informatics, 122, 499–502.
- Colligan, L., Potts, H. W., Finn, C. T., & Sinkin, R. A. (2015). Cognitive workload changes for nurses transitioning from a legacy system with paper documentation to a commercial electronic health record. International Journal of Medical Informatics, 84(7), 469–476. https://doi.org/10.1016/j.ijmedinf.2015.03.003
- Cordero, L., Kuehn, L., Kumar, R. R., & Mekhjian, H. S. (2004). Impact of computerized physician order entry on clinical practice in a newborn intensive care unit. Journal of Perinatology, 24(2), 88–93. https://doi.org/10.1038/sj.jp.7211000
- Cornell, P., Herrin-Griffith, D., Keim, C., Petschonek, S., Sanders, A. M., D'Mello, S., … Shepherd, G. (2010). Transforming nursing workflow, part 1: The chaotic nature of nurse activities. The Journal of Nursing Administration, 40(9), 366–373. https://doi.org/10.1097/NNA.0b013e3181ee4261
- Cornell, P., Riordan, M., Townsend-Gervis, M., & Mobley, R. (2011). Barriers to critical thinking: Workflow interruptions and task switching among nurses. The Journal of Nursing Administration, 41(10), 407–414. https://doi.org/10.1097/NNA.0b013e31822edd42
- Crane, P. W., Zhou, Y., Sun, Y., Lin, L., & Schneider, S. (2015). Is self-reporting of emergency department workload valid? Academic Emergency Medicine, 22, S355.
- Darbyshire, P. (2004). ‘Rage against the machine?’: Nurses' and midwives' experiences of using computerized patient information systems for clinical information. Journal of Clinical Nursing, 13(1), 17–25. https://doi.org/10.1111/j.1365-2702.2006.01180.x
- Dearmon, V., Roussel, L., Buckner, E. B., Mulekar, M., Pomrenke, B., Salas, S., … Brown, A. (2013). Transforming Care at the Bedside (TCAB): Enhancing direct care and value-added care. Journal of Nursing Management, 21(4), 668–678. https://doi.org/10.1111/j.1365-2834.2012.01412.x
- Dwibedi, N., Sansgiry, S. S., Frost, C. P., Dasgupta, A., Jacob, S. M., Tipton, J. A., & Shippy, A. A. (2011). Effect of bar-code-assisted medication administration on nurses' activities in an intensive care unit: A time-motion study. American Journal of Health-System Pharmacy, 68(11), 1026–1031. https://doi.org/10.2146/ajhp100382
- Dwibedi, N., Sansgiry, S. S., Frost, C. P., Johnson, M. L., Dasgupta, A., Tipton, J. A., … Shippy, A. A. (2012). Bedside barcode technology: Impact on medication administration tasks in an intensive care unit. Hospital Pharmacy, 47(5), 360–366. https://doi.org/10.1310/hpj4705-360
10.1310/hpj4705-360 Google Scholar
- Edwards, A., Fitzpatrick, L. A., Augustine, S., Trzebucki, A., Cheng, S. L., Presseau, C., … Kachnowski, S. (2009). Synchronous communication facilitates interruptive workflow for attending physicians and nurses in clinical settings. International Journal of Medical Informatics, 78(9), 629–637. https://doi.org/10.1016/j.ijmedinf.2009.04.006
- Fahey, L., Lopez, K. D., Storfjell, J., & Keenan, G. (2013). Expanding potential of radiofrequency nurse call systems to measure nursing time in patient rooms. The Journal of Nursing Administration, 43(5), 302–307. https://doi.org/10.1097/NNA.0b013e31828eebe1
- Gomes, M., Hash, P., Orsolini, L., Watkins, A., & Mazzoccoli, A. (2016). Connecting professional practice and technology at the bedside: Nurses' beliefs about using an electronic health record and their ability to incorporate professional and patient-centered nursing activities in patient care. Computers, Informatics, Nursing, 34(12), 578–586. https://doi.org/10.1097/CIN.0000000000000280
- Greenhalgh, T., Wherton, J., Papoutsi, C., Lynch, J., Hughes, G., A'Court, C., … Shaw, S. (2018). Analysing the role of complexity in explaining the fortunes of technology programmes: Empirical application of the NASSS framework. BMC Medicine, 16(1), 66. https://doi.org/10.1186/s12916-018-1050-6
- Hakes, B., & Whittington, J. (2008). Assessing the impact of an electronic medical record on nurse documentation time. Computers, Informatics, Nursing, 26(4), 234–241. https://doi.org/10.1097/01.NCN.0000304801.00628.ab
- Harper, E. M. (2012). Staffing based on evidence: Can health information technology make it possible? Nursing Economics, 30(5), 262.
- Herdman, T. H., Burgess, L. P., Ebright, P. R., Paulson, S. S., Powell-Cope, G., Hancock, H., … Cadman, E. C. (2009). Impact of continuous vigilance monitoring on nursing workflow. The Journal of Nursing Administration, 39(3), 123–129. https://doi.org/10.1097/NNA.0b013e31819894c8
- Hong, Q. N., Pluye, P., Fàbregues, S., Bartlett, G., Boardman, F., Cargo, M., … Vedel, I. (2018). Mixed Methods Appraisal Tool (MMAT), version 2018. Registration of Copyright (#1148552), Canada. Retrieved from http://mixedmethodsappraisaltoolpublic.pbworks.com/w/file/fetch/127916259/MMAT_2018_criteria-manual_2018-08-01_ENG.pdf
- Hsieh, H. Y., Henker, R., Ren, D., Chien, W. Y., Chang, J. P., Chen, L., & Tuite, P. K. (2016). Improving effectiveness and satisfaction of an electronic charting system in Taiwan. Clinical Nurse Specialist, 30(6), E1–E6. https://doi.org/10.1097/NUR.0000000000000250
- Hurst, K. (2008). UK ward design: Patient dependency, nursing workload, staffing and quality–An observational study. International Journal of Nursing Studies, 45(3), 370–381. https://doi.org/10.1016/j.ijnurstu.2006.09.007
- Jackson, J. (2019). Nursing work. Retrieved from http://jenniferjacksonrn.org/nursing-work/
- Jedwab, R. M., Chalmers, C., Dobroff, N., & Redley, B. (2019). Measuring nursing benefits of an electronic medical record system: A scoping review. Collegian, 26(5), 562–582. https://doi.org/10.1016/j.colegn.2019.01.003
- Kalisch, B. (2006). Missed nursing care: A qualitative study. Journal of Nursing Care Quality, 21(4), 306–313. https://doi.org/10.1097/00001786-200610000-00006
- Kalisch, B., & Aebersold, M. (2010). Interruptions and multitasking in nursing care. The Joint Commission Journal on Quality and Patient Safety, 36(3), 126–132. https://doi.org/10.1016/s1553-7250(10)36021-1
- Kalisch, B., & Lee, K. H. (2014). Staffing and job satisfaction: Nurses and nursing assistants. Journal of Nursing Management, 22(4), 465–471. https://doi.org/10.1111/jonm.12012
- Korst, L. M., Eusebio-Angeja, A. C., Chamorro, T., Aydin, C. E., & Gregory, K. D. (2003). Nursing documentation time during implementation of an electronic medical record. Journal of Nursing Administration, 33, 24–30. https://doi.org/10.1097/00005110-200301000-00006
- Kossman, S. P., & Scheidenhelm, S. L. (2008). Nurses' perceptions of the impact of electronic health records on work and patient outcomes. Computers, Informatics, Nursing, 26(2), 69–77. https://doi.org/10.1097/01.NCN.0000304775.40531.67
- Kozlowski, D., Hutchinson, M., Hurley, J., Rowley, J., & Sutherland, J. (2017). The role of emotion in clinical decision making: An integrative literature review. BMC Medical Education, 17(1), 255. https://doi.org/10.1186/s12909-017-1089-7
- Kutney-Lee, A., & Kelly, D. (2011). The effect of hospital electronic health record adoption on nurse-assessed quality of care and patient safety. Journal of Nursing Administration, 41(11), 466–472. https://doi.org/10.1097/NNA.0b013e3182346e4b
- Lau, F., Kuziemsky, C., Price, M., & Gardner, J. (2010). A review on systematic reviews of health information system studies. Journal of the American Medical Informatics Association, 17(6), 637–645. https://doi.org/10.1136/jamia.2010.004838
- Lee, T., Mills, M. E., & Lu, M. (2008). Impact of a nursing information system on practice patterns in Taiwan. Computers, Informatics, Nursing, 26(4), 207–214. https://doi.org/10.1097/01.NCN.0000304807.69240.9e
- Leung, M., Chan, K. K. C., Wong, W. L., & Law, A. C. B. (2018). Impact of IPMOE on nursing tasks in the medical ward: A time-motion study. International Journal of Nursing Sciences, 5(1), 50–56. https://doi.org/10.1016/j.ijnss.2018.01.003
- Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & PRISMA Group (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. BMJ, 339, b2535. https://doi.org/10.1371/journal.pmed.1000097
- Moon, L. A., Clancy, G., Welton, J., & Harper, E. (2019). Nursing value user stories: A value measurement method for linking nurse contribution to patient outcomes. Computers, Informatics, Nursing, 37(3), 161–170. https://doi.org/10.1097/CIN.0000000000000520
- Needleman, J. (2013). Increasing acuity, increasing technology, and the changing demands on nurses. Nursing Economics, 31(4), 200–202.
- O'Connor, P., Ritchie, J., Drouin, S., & Covell, C. L. (2012). Redesigning the workplace for 21st century healthcare. Healthcare Quarterly, 15, 30–35. https://doi.org/10.12927/hcq.2012.22844
- Pamplin, J., Nemeth, C. P., Serio-Melvin, M. L., Murray, S. J., Rule, G. T., Veinott, E. S., … Salinas, J. (2019). Improving clinician decisions and communication in critical care using novel information technology. Military Medicine, 185(1-2), usz151. https://doi.org/10.1093/milmed/usz151
- Poissant, L., Pereira, J., Tamblyn, R., & Kawasumi, Y. (2005). The impact of electronic health records on time efficiency of physicians and nurses: A systematic review. Journal of the American Medical Informatics Association, 12(5), 505–516. https://doi.org/10.1197/jamia.M1700
- Poon, E. G., Keohane, C., Featherstone, E., Hays, B., Dervan, A., Woolf, S., … Gandhi, T. K. (2006). Impact of barcode medication administration technology on how nurses spend their time on clinical care. AMIA Annual Symposium Proceedings, 21, 1065.
- Probst, C. A., Carter, M., Cadigan, C., Dalcour, C., Cassity, C., Quinn, P., … Xiao, Y. (2017). Utilizing a human factors nursing worksystem improvement framework to increase nurses' time at the bedside and enhance safety. The Journal of Nursing Administration, 47(2), 94–100. https://doi.org/10.1097/NNA.00000000000000446
- Radecki, R. P., & Medow, M. A. (2007). Cognitive debiasing through sparklines in clinical data displays. AMIA Annuual Symposium Proceedings, 1085, 1085.
- Ravat, F., Percier, L., Akkal, R., Morris, W., Fontaine, M., Payre, J., & Poupelin, J. C. (2014). Working time and workload of nurses: The experience of a burn center in a high income country. Burns, 40(6), 1133–1140. https://doi.org/10.1016/j.burns.2014.01.002
- Read-Brown, S., Sanders, D. S., Brown, A. S., Yackel, T. R., Choi, D., Tu, D. C., & Chiang, M. F. (2013). Time-motion analysis of clinical nursing documentation during implementation of an electronic operating room management system for ophthalmic surgery. AMIA Annual Symposium Proceedings, 2013, 1195–1204.
- Reed, C. C., Minnick, A. F., & Dietrich, M. S. (2018). Nurses' responses to interruptions during medication tasks: A time and motion study. International Journal of Nursing Studies, 82, 113–120. https://doi.org/10.1016/j.ijnurstu.2018.03.017
- Rose, J., & Glass, N. (2010). An Australian investigation of emotional work, emotional well-being and professional practice: An emancipatory inquiry. Journal of Clinical Nursing, 19(9–10), 1405–1414. https://doi.org/10.1111/j.1365-2702.2009.02997.x
- Roumeliotis, N., Parisien, G., Charette, S., Arpin, E., Brunet, F., & Jouvet, P. (2018). Reorganizing care with the implementation of electronic medical records: A time-motion study in the PICU. Pediatric Critical Care Medicine, 19(4), e172–e179. https://doi.org/10.1097/PCC.0000000000001450
- Rushton, C., Crilly, J., Adeleye, A., Grealish, L., Beylacq, M., & Forbes, M. (2017). Scoping review of medical assessment units and older people with complex health needs. Australasian Journal on Ageing, 36(1), 19–25. https://doi.org/10.1111/ajag.12353
- Schachner, M. B., Recondo, F. J., Sommer, J. A., González, Z. A., García, G. M., Luna, D. R., & Benítez, S. E. (2015). Pre-implementation study of a nursing e-chart: How nurses use their time. Studies in Health Technology and Informatics, 216, 255–258.
- Schenk, E., Schleyer, R., Jones, C. R., Fincham, S., Daratha, K. B., & Monsen, K. A. (2018). Impact of adoption of a comprehensive electronic health record on nursing work and caring efficacy. Computers, Informatics, Nursing, 36(7), 331–339. https://doi.org/10.1097/CIN.0000000000000441
- Stevenson, J. E., Nilsson, G. C., Petersson, G. I., & Johansson, P. E. (2010). Nurses' experience of using electronic patient records in everyday practice in acute/inpatient ward settings: A literature review. Health Informatics Journal, 16(1), 63–72. https://doi.org/10.1177/1460458209345901
- Sulmasy, D. P., & Sood, J. R. (2003). Factors associated with the time nurses spend at the bedsides of seriously ill patients with poor prognoses. Medical Care, 41, 458–466. https://doi.org/10.1097/01.MLR.0000053226.38288.18
- Tang, Z., Mazabob, J., Weavind, L., Thomas, E., & Johnson, T. R. (2006). A time-motion study of registered nurses' workflow in intensive care unit remote monitoring. AMIA Annuual Symposium Proceedings, 2006, 759–763.
- Topaz, M., Ronquillo, C., Peltonen, L. M., Pruinelli, L., Sarmiento, R. F., Badger, M. K., … Lee, Y. L. (2016). Nurse informaticians report low satisfaction and multi-level concerns with electronic health records: Results from an international survey. AMIA Annuual Symposium Proceedings, 2016, 2016–2025.
- Twigg, D., & Duffield, C. (2009). A review of workload measures: A context for a new staffing methodology in Western Australia. International Journal of Nursing Studies, 46(1), 132–140. https://doi.org/10.1016/j.ijnurstu.2008.08.005
- Walter, S. R., Li, L., Dunsmuir, W. T., & Westbrook, J. I. (2014). Managing competing demands through task-switching and multitasking: A multi-setting observational study of 200 clinicians over 1000 hours. BMJ Quality & Safety, 23(3), 231–241. https://doi.org/10.1136/bmjqs-2013-002097
- Westbrook, J. I., Coiera, E., Dunsmuir, W. T., Brown, B. M., Kelk, N., Paoloni, R., & Tran, C. (2010). The impact of interruptions on clinical task completion. BMJ Quality & Safety, 19(4), 284–289. https://doi.org/10.1136/qshc.2009.039255
- Westbrook, J. I., Li, L., Georgiou, A., Paoloni, R., & Cullen, J. (2013). Impact of an electronic medication management system on hospital doctors' and nurses' work: A controlled pre-post, time and motion study. Journal of the American Medical Informatics Association, 20(6), 1150–1158. https://doi.org/10.1136/amiajnl-2012-001414
- Whittemore, R., & Knafl, K. (2005). The integrative review: Updated methodology. Journal of Advanced Nursing, 52(5), 546–553. https://doi.org/10.1111/j.1365-2648.2005.03621.x
- Willis, K., Brown, C. R., Sahlin, I., Svensson, B., Arnetz, B. B., & Arnetz, J. E. (2005). Working under pressure: A pilot study of nurse work in a postoperative setting. Clinical Nurse Specialist, 19(2), 87–91. https://doi.org/10.1097/00002800-200503000-00068
- Wong, D., Bonnici, T., Knight, J., Gerry, S., Turton, J., & Watkinson, P. (2017). A ward-based time study of paper and electronic documentation for recording vital sign observations. Journal of the American Medical Informatics Association, 24(4), 717–721. https://doi.org/10.1093/jamia/ocw186
- Wong, D. H., Gallegos, Y., Weinger, M. B., Clack, S., Slagle, J., & Anderson, C. T. (2003). Changes in intensive care unit nurse task activity after installation of a third-generation intensive care unit information system. Critical Care Medicine, 31(10), 2488–2494. https://doi.org/10.1097/01.CCM.0000089637.53301.EF
- Yee, T., Needleman, J., Pearson, M., Parkerton, P., Parkerton, M., & Wolstein, J. (2012). The influence of integrated electronic medical records and computerized nursing notes on nurses' time spent in documentation. Computers, Informatics, Nursing, 30(6), 287–292. https://doi.org/10.1097/NXN.0b013e31824af835
- Yen, K., Shane, E. L., Pawar, S. S., Schwendel, N. D., Zimmanck, R. J., & Gorelick, M. H. (2009). Time motion study in a pediatric emergency department before and after computer physician order entry. Annals of Emergency Medicine, 53(4), 462–468.e1. https://doi.org/10.1016/j.annemergmed.2008.09.018
- Yoon, J. Y., King, B., Pecanac, K., Brown, R., Mahoney, J., & Kuo, F. (2015). Comparison of time-and-motion observations and self-reports to capture mobility-related nursing care activities for hospitalized older adults. Research in Gerontological Nursing, 8(3), 110–117. https://doi.org/10.3928/19404921-20150304-02
- Zadvinskis, I. M., Chipps, E., & Yen, P.-Y. (2014). Exploring nurses' confirmed expectations regarding health IT: A phenomenological study. International Journal of Medical Informatics, 83(2), 89–98. https://doi.org/10.1016/j.ijmedinf.2013.11.001
- Zhang, Y., Monsen, K. A., Adam, T. J., Pieczkiewicz, D. S., Daman, M., & Melton, G. B. (2011). Systematic refinement of a health information technology time and motion workflow instrument for inpatient nursing care using a standardized interface terminology. AMIA Annuual Symposium Proceedings, 2011, 1621–1629.
- Zuzelo, P. R., Gettis, C., Hansell, A. W., & Thomas, L. (2008). Describing the influence of technologies on registered nurses' work. Clinical Nurse Specialist, 22(3), 132–140. https://doi.org/10.1097/01.NUR.0000311693.92662.14
Citing Literature
