Validity and Reliability of a New Measure of Nursing Experience With Unintended Consequences of Electronic Health Records.
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Final Accepted Manuscript
Affiliation
Univ Arizona, Coll NursingIssue Date
2016-10Keywords
BarrierElectronic health record
Electronic medical record
Measurement
Nursing
Nursing informatics
Patient safety
Professional Practice Environment
Psychometric analysis
Unintended consequences
Workaround
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LIPPINCOTT WILLIAMS & WILKINSCitation
Validity and Reliability of a New Measure of Nursing Experience With Unintended Consequences of Electronic Health Records. 2016, 34 (10):436-447 Comput Inform NursRights
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
1538-9774PubMed ID
27551947Version
Final accepted manuscriptSponsors
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.aspxae974a485f413a2113503eed53cd6c53
10.1097/CIN.0000000000000285
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