Patient experience of the use of bedside information technology in acute care and their perceptions of its impact on nurse patient interactions.

Abstract

BACKGROUND: The introduction of point-of-care (POC) health information technology (HIT), is expected to impact patients' healthcare experience. While recognising the potential benefits of POC-HIT, there is limited research from the patients' perspective therefore, this project explored patients' experiences of nurses using the POC system during key clinical activities. METHODS: A multi-methods naturalistic descriptive study design was used. Stage One involved two periods of observation and subsequent semi-structured interview, Stage Two consisted of a follow-up telephone survey, using the Picker Patient Experience questionnaire with supplemental technology related questions, within two weeks of discharge. Participants were also asked about their confidence using technology. RESULTS: A total of 28 participants were recruited across three acute inpatients wards, 24 partook in one or both stages of the research. The mean age of participants were 69 years (SD 11), males (63%). Primary reasons for admissions were: 25% oncology, 13% general medical, 29% general surgical and 33% orthopaedic patients. Patients' self-perception of their confidence using technology varied: 29% not confident, 38% somewhat confident and 33% completely confident. There were 93 nursing staff observed providing care, 11% were in charge of the shift and 89% bedside nurses. Nurses adopted various approaches to using the POC-HIT system with some staff demonstrating to patients how the system was being used to enhance care. Patients' were receptive to the use of technology to support clinical care, irrespective of their own confidence using technology. However, patients reported that nurse's use of the POC-HIT could impede communication with nursing staff. Participants with higher confidence using technology were better at recognising the potential for POC-HIT use to support self-directed care, and to facilitate continuity of care. CONCLUSION: Participants recognised the benefits of POC-HIT to support clinical practice but generally desired greater engagement with the nurses' use of the system.