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Title: Investigating the mediating role of nursing information systems using activity theory.
Epworth Authors: O'Connor, Louise
Wickramasinghe, Nilmini
Other Authors: Nguyen, Lemai
Keywords: Nursing Information Systems
Activity Theory
Nursing Documentation
Delivery of Care
Patient Data
Clinical Communication
Clinical Interventions
Clincial Outcome
Clinical Support Tools
Accessibilty of Data
Divisions of Labour
Nurse Documentation Relationship
Patient-Clinician Dynamics
Healthcare Professionals
Technology Implementation
Change Management
Chair of Health Informatics Management, Epworth HealthCare, Victoria, Australia
Issue Date: Jun-2017
Citation: Epworth Research Institute Research Week 2017; Poster 32: pp 56
Conference Name: Epworth Research Institute Research Week 2017
Conference Location: Epworth Research Institute, Victoria, Australia
Abstract: INTRODUCTION/ BACKGROUND: Nursing documentation is essential for keeping accurate records of delivered care and patient data, as well as supporting clinical communication, decision-making, interventions and outcome evaluation. Nursing information systems (NIS) are increasingly introduced as a support tool to enable nurses to document and access real-time and accurate patient care data. This study summarises findings from our examination of the enabling role of two nursing information systems respectively in one public and one private hospital in Victoria. METHOD: Multiple case studies were adopted. Activity Theory (AT) was used as the theoretical lens to examine the mediating roles. AT suggests that the relationship between a human actor and his/her objective/goal is mediated by tools and the collective elements including Community, Rules, and Division of Labour. Multi-methods were adopted for data collection and analysis. RESULTS: Case study 1: the nurse-documentation relationship was mediated by the new tool (NIS) including change to documentation location which impacted patient clinician dynamics. Mapping with AT, we note that the dynamics of the interactions between nurses (as actors), NIS (as new tool), and nursing documentation (as objective) are appropriated to reproduce the new technology-enabled documentation practice. Fidelity of NIS can be examined through the mediating role of the system in terms of how it reflects rules, division of labour, its potential to support communication and collective care between nurses and other healthcare professionals; i.e. the community. Initial findings from the second case study suggest a higher level of complexity as it involves multiple actors using the second system for multiple activities. CONCLUSION: Both case studies examined the mediating role for NIS during implementation in naturalistic acute care hospital contexts and reveal how the new nursing documentation culture and practice emerges; socially constructed and technically mediated. Both studies suggest the importance of engaging nurses in technology implementation, training and change management.
Type: Conference Poster
Affiliated Organisations: Deakin University
Type of Clinical Study or Trial: Case Series and Case Reports
Appears in Collections:Health Informatics
Research Month

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