@文章{info:doi/10.2196/39596，作者="Jedwab, Rebecca M和Manias, Elizabeth和Hutchinson, Alison M和Dobroff, Naomi和Redley, Bernice"，标题="实施全组织电子病历后的护士经验:定性描述性研究"，期刊="JMIR护理"，年="2022"，月=" 7 "，日="26"，卷="5"，数="1"，页="e39596"，关键词="电脑化病历系统;COVID-19;实现科学;动机;护士;背景:关于电子病历(EMR)系统对临床医生的影响的报告是混合的。目前，护士采用大规模、多站点EMR系统的经验尚未被调查。护士是最大的卫生保健劳动力;因此，必须调查和理解实施EMR的影响，以确保患者护理质量、护士工作的变化和护士本身不会受到负面影响。目的:本研究旨在探讨澳大利亚护士在全组织EMR系统实施后的经验。 Methods: This qualitative descriptive study used focus group and individual interviews and an open-ended survey question to collect data between 12 and 18 months after the implementation of an EMR across 6 hospital sites of a large health care organization in Victoria, Australia. Data were collected between November 2020 and June 2021, coinciding with the COVID-19 pandemic. Analysis comprised complementary inductive and deductive approaches. Specifically, reflexive thematic analysis was followed by framework analysis by the coding of data as barriers or facilitators to nurses' use of the EMR using the Theoretical Domains Framework. Results: A total of 158 nurses participated in this study. The EMR implementation dramatically changed nurses' work and how they viewed their profession, and nurses were still adapting to the EMR implementation 18 months after implementation. Reflexive thematic analysis led to the development of 2 themes: An unintentional divide captured nurses' feelings of division related to how using the EMR affected nurses, patient care, and the broader nursing profession. This time, it's personal detailed nurses' beliefs about the EMR implementation leading to bigger changes to nurses as individuals and nursing as a profession than other changes that nurses have experienced within the health care organization. The most frequent barriers to EMR use by nurses were related to the Theoretical Domains Framework domain of environmental context and resources. Facilitators of EMR use were most often related to memory, attention, and decision processes. Most barriers and facilitators were related to motivation. Conclusions: Nurses perceived EMR implementation to have a mixed impact on the provision of quality patient care and on their colleagues. Implementing technology in a health care setting was perceived as a complex endeavor that impacted nurses' perceptions of their autonomy, ways of working, and professional roles. Potential negative consequences were related to nursing workforce retention and patient care delivery. Motivation was the main behavioral driver for nurses' adoption of EMR systems and hence a key consideration for implementing interventions or organizational changes directed at nurses. ", issn="2562-7600", doi="10.2196/39596", url="https://nursing.www.mybigtv.com/2022/1/e39596", url="https://doi.org/10.2196/39596", url="http://www.ncbi.nlm.nih.gov/pubmed/35881417" }