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AnteayerJournal of Clinical Nursing

Nurses' Perceptions of Facilitators and Barriers to Their Acceptance of Electronic Health Records: A Mixed‐Method Systematic Review

ABSTRACT

Background

International eHealth strategies incorporate the adoption of electronic health records to enhance the delivery of integrated healthcare and improve patient outcomes. Nurses’ acceptance of electronic health records is crucial for their successful implementation.

Aim

To synthesise evidence from empirical studies to explore the nurses' perceptions of facilitators and barriers and the influence of moderating factors on their acceptance of electronic health records.

Design

A convergent integrated mixed-method systematic review following the JBI methodology.

Data Sources

CINAHL Plus with Full Text, Medline [EBSCO], ProQuest, PubMed, Scopus, Google Scholar and Open Grey were searched on 28 March 2023 for primary research studies published between 2018 and 2023.

Review Methods

Studies were screened by two independent reviewers adhering to predetermined inclusion criteria. A convergent integrated synthesis was conducted and deductive analysis was framed by The Unified Theory of Acceptance and Use of Technology model.

Results

Thirteen studies were included and appraised using the mixed-method appraisal tool. Facilitators of nurses' acceptance of electronic health records included increased efficiency, improved access to information, management support and training. Nurses identified increased documentation burden, threats to patient confidentiality, difficult navigation and inadequate IT support and training as barriers to their acceptance. The influence of moderators on nurses' acceptance of electronic health records remains unclear.

Conclusion

This review provides insights into nurses' perceptions of factors influencing electronic health record acceptance. Addressing these issues during adoption and further exploring the impact of moderators can improve acceptance and minimise unintended consequences.

Implications

Nurse leaders are key in empowering nurses to accept electronic health records. The nursing profession must participate in all phases of electronic health record design and implementation to ensure that they complement nursing practice.

Reporting Method

PRISMA 2020 Statement.

No Patient or Publication Contribution

This is a review of primary research.

Nursing‐Based Sleep Promotion Intervention Effectiveness for Post Cardiac Surgery Patients: Systematic Review

ABSTRACT

Background

Sleep is a fundamental prerequisite for physical and mental health. Poor quality of sleep is common among post-cardiac surgery patients and leads to serious health conditions.

Objective

To conduct a systematic review that investigates the effectiveness of eye masks, earplugs and deep-breathing exercise on sleep quality among post-cardiac surgery patients.

Design

A systematic review of interventional studies was established to meet the PRISMA guidelines.

Methods

PRISMA guidelines were used to assess the findings of 11 selected studies that met the inclusion criteria, published between 2007 and 2023 across four databases: CINAHL, JDNR, MEDLINE and PubMed. The search was conducted on 23 November 2023.

Results

The 11 most eligible studies were analysed. All of them were interventional, encompassing a total of 787 participants. Randomised controlled trials were the most common design. Interventions included eye masks, earplugs and deep-breathing exercises. The Richards-Campbell Sleep Questionnaire was the most used assessment scale. Most of the reviewed studies found that the use of non-pharmacological interventions (eye masks, earplugs and deep-breathing exercise) significantly improves the quality of sleep. These interventions were also found to have potentially positive effects on reducing pain and delirium experienced by patients after undergoing cardiac surgery.

Conclusions

Non-pharmacological interventions (eye masks, earplugs and deep-breathing exercise) were found to be cost-effective interventions that could be easily applied in the clinical setting and are effective in improving the quality of sleep among patients after cardiac surgery.

The impact of electronic and self‐rostering systems on healthcare organisations and healthcare workers: A mixed‐method systematic review

Abstract

Aim

To synthesise evidence from studies that explored the impact of electronic and self-rostering systems to schedule staff on healthcare organisations and healthcare workers.

Design

Mixed-method systematic review.

Methods

Studies were screened by two independent reviewers and data were extracted using standardised data extraction tables. The quality of studies was assessed, and parallel-results convergent synthesis was conducted.

Data Sources

Academic Search Complete, CINAHL, ERIC, MEDLINE, PsycINFO and PsycARTICLES were searched on January 3, 2023.

Results

Eighteen studies were included (10 quantitative descriptive studies, seven non-randomised studies and one qualitative study). Studies examined two rostering interventions including self-rostering (n = 12) and electronic rostering (n = 6). It was found that the implementation of electronic and self-rostering systems for staff scheduling impacted positively on both, healthcare workers and healthcare organisations. Benefits included enhanced roster efficiency, staff satisfaction, greater control and empowerment, improved work-life balance, higher staff retention and reduced turnover, decreased absence rates and enhanced healthcare efficiency. However, self-rostering was found to be less equitable than fixed rostering, was associated with increased overtime, and correlated with a higher frequency of staff requests for shift changes.

Conclusion

The impact of electronic and self-rostering systems to schedule staff on healthcare organisations and healthcare workers’ outcomes was predominantly positive. Further randomised controlled trials and longitudinal studies are warranted to evaluate the long-term impact of various rostering systems, including electronic and self-rostering systems.

Implications for Healthcare

Rostering is a multifaceted responsibility for healthcare administrators, impacting patient care quality, workforce planning and healthcare expenditure.

Impact

Given that healthcare staffing costs constitute a substantial portion of global healthcare expenditure, efficient and strategic resource management, inclusive of healthcare staff rostering, is imperative.

Reporting Method

The 27-item Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) checklist.

Patient or Public Contribution

No Patient or Public Contribution.

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