¿MÁS TECNOLOGÍA, MENOS CUIDADOS? Evaluación de la convivencia y conveniencia de los registros a pies de cama del paciente, con tabletas (tablets), con los cuidados de enfermería

Identifier:  TDX:4102

Handle: https://hdl.handle.net/20.500.11797/TDX4102

Authors:  Pérez Martí, Montserrat

Abstract:
Electronic health records (EHR) at the point of care improve efficiency, quality of care, patient safety, communication and decrease time spent on patient records. The main objectives were to evaluate whether making EHR available at the point of care with tablets, in the internal medicine units, reduces nurses’ time spent on records compared with the current system and to describe nurses’ perceptions and experiences towards patient's bedside records and how this fits in with the care situation. A mixed study was carried out from February 2017 to April 2018 to analyze the time in movement (used in computer applications) during the assessment of all patients at the beginning of the work shift and their complete record, before and after the use of tablets. Analysis was conducted with contingency tables, ANOVA and comparation averages with Student t or Wilconxon in case of non-normality and the distance with Cohen d. The level of significance marked was p<0,05. The mean time spent per patient was lower with the tablet group ((x ) ̅4,22±0,14 min) than the control group ((x ) ̅ 4,66±0,12 min), (W=-3,208, p=0,001) and the effect was low(d=0,44) between groups. Similar results were obtained for the afternoon shift, but not for the night shift. The mean age of the 'non-participants' was higher (49,57± 2,92 years) (p = 0,007) and the 'non-participants' on the night shift had a worse perception of using tablets. Also, a qualitative content analysis was conducted of the material from the participant observation and the focus groups. Nurses' perceptions were that EHR at the point of care are an effective tool to decrease the time spent on registration. However, their acceptance is hinder by workloads, working conditions, difficulties in working with information and communications technologies (ICT) and the software used. This research highlights the needs for software adapted to mobile devices, the integration of data, the standardization of work methodologies, the review of work ratios, attendance at courses in registries and ICT, and the involvement of nurses in the development.