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    Validity and Reliability of a New Measure of Nursing Experience With Unintended Consequences of Electronic Health Records.

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    Name:
    CIN-D-16-00014_R1_(1).pdf
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    1.460Mb
    Format:
    PDF
    Description:
    Final Accepted Manuscript
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    Author
    Gephart, Sheila M
    Bristol, Alycia A
    Dye, Judy L
    Finley, Brooke A
    Carrington, Jane M
    Affiliation
    Univ Arizona, Coll Nursing
    Issue Date
    2016-10
    Keywords
    Barrier
    Electronic health record
    Electronic medical record
    Measurement
    Nursing
    Nursing informatics
    Patient safety
    Professional Practice Environment
    Psychometric analysis
    Unintended consequences
    Workaround
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    Publisher
    LIPPINCOTT WILLIAMS & WILKINS
    Citation
    Validity and Reliability of a New Measure of Nursing Experience With Unintended Consequences of Electronic Health Records. 2016, 34 (10):436-447 Comput Inform Nurs
    Journal
    CIN: Computers, Informatics, Nursing
    Rights
    Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.
    Collection Information
    This item from the UA Faculty Publications collection is made available by the University of Arizona with support from the University of Arizona Libraries. If you have questions, please contact us at repository@u.library.arizona.edu.
    Abstract
    Unintended consequences of electronic health records represent undesired effects on individuals or systems, which may contradict initial goals and impact patient care. The purpose of this study was to determine the extent to which a new quantitative measure called the Carrington-Gephart Unintended Consequences of Electronic Health Record Questionnaire (CG-UCE-Q) was valid and reliable. Then, it was used to describe acute care nurses' experience with unintended consequences of electronic health records and relate them to the professional practice environment. Acceptable content validity was achieved for two rounds of surveys with nursing informatics experts (n = 5). Then, acute care nurses (n = 144) were recruited locally and nationally to complete the survey and describe the frequency with which they encounter unintended consequences in daily work. Principal component analysis with oblique rotation was applied to evaluate construct validity. Correlational analysis with measures of the professional practice environment and workarounds was used to evaluate convergent validity. Test-retest reliability was measured in the local sample (N = 68). Explanation for 63% of the variance across six subscales (patient safety, system design, workload issues, workarounds, technology barriers, and sociotechnical impact) supported construct validity. Relationships were significant between subscales for electronic health record-related threats to patient safety and low autonomy/leadership (P < .01), poor communication about patients (P < .01), and low control over practice (P < .01). The most frequent sources of unintended consequences were increased workload, interruptions that shifted tasks from the computer, altered workflow, and the need to duplicate data entry. Convergent validity of the CG-UCE-Q was moderately supported with both the context and processes of workarounds with strong relationships identified for when nurses perceived a block and altered process to work around it to subscales in the CG-UCE-Q for electronic health record system design (P < .01) and technological barriers (P < .01).
    Note
    12 Month Embargo.
    ISSN
    1538-9774
    PubMed ID
    27551947
    DOI
    10.1097/CIN.0000000000000285
    Version
    Final accepted manuscript
    Sponsors
    Robert Wood Johnson Foundation Nurse Faculty Scholars Program; Agency for Healthcare Research and Quality [K08HS022908]
    Additional Links
    http://journals.lww.com/cinjournal/Citation/2016/10000/Validity_and_Reliability_of_a_New_Measure_of.8.aspx
    ae974a485f413a2113503eed53cd6c53
    10.1097/CIN.0000000000000285
    Scopus Count
    Collections
    UA Faculty Publications

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