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dc.contributor.authorGephart, Sheila M
dc.contributor.authorBristol, Alycia A
dc.contributor.authorDye, Judy L
dc.contributor.authorFinley, Brooke A
dc.contributor.authorCarrington, Jane M
dc.date.accessioned2016-12-12T21:42:03Z
dc.date.available2016-12-12T21:42:03Z
dc.date.issued2016-10
dc.identifier.citationValidity and Reliability of a New Measure of Nursing Experience With Unintended Consequences of Electronic Health Records. 2016, 34 (10):436-447 Comput Inform Nursen
dc.identifier.issn1538-9774
dc.identifier.pmid27551947
dc.identifier.doi10.1097/CIN.0000000000000285
dc.identifier.urihttp://hdl.handle.net/10150/621591
dc.description.abstractUnintended 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).
dc.description.sponsorshipRobert Wood Johnson Foundation Nurse Faculty Scholars Program; Agency for Healthcare Research and Quality [K08HS022908]en
dc.language.isoenen
dc.publisherLIPPINCOTT WILLIAMS & WILKINSen
dc.relation.urlhttp://journals.lww.com/cinjournal/Citation/2016/10000/Validity_and_Reliability_of_a_New_Measure_of.8.aspxen
dc.rightsCopyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.en
dc.rights.urihttp://rightsstatements.org/vocab/InC/1.0/
dc.subjectBarrieren
dc.subjectElectronic health recorden
dc.subjectElectronic medical recorden
dc.subjectMeasurementen
dc.subjectNursingen
dc.subjectNursing informaticsen
dc.subjectPatient safetyen
dc.subjectProfessional Practice Environmenten
dc.subjectPsychometric analysisen
dc.subjectUnintended consequencesen
dc.subjectWorkarounden
dc.titleValidity and Reliability of a New Measure of Nursing Experience With Unintended Consequences of Electronic Health Records.en
dc.typeArticleen
dc.contributor.departmentUniv Arizona, Coll Nursingen
dc.identifier.journalCIN: Computers, Informatics, Nursingen
dc.description.note12 Month Embargo.en
dc.description.collectioninformationThis 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.en
dc.eprint.versionFinal accepted manuscripten
refterms.dateFOA2017-11-01T00:00:00Z
html.description.abstractUnintended 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).


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