Nurses using information technology: The impact on the nurses' practice

This research focused on exploring the lived experience of the professional nurse adapting and integrating information technology (IT) into her clinical work. This research was conducted using a co-investigator approach that included both collaborative and independent components to the research. The research questions were delineated through the lens of two distinct perspectives, (a) the impact of the nurse-IT interaction on the nurse's role in caring for patients and (b) the impact of nurse-IT interaction on social processes and relationships. The specific focus of this researcher was on the nurse interacting with IT in her role of managing the consistently changing nursing care for a group of patients, to understand the ordinary methods that nurses use in carrying out their practice of nursing, while using IT. A qualitative approach was used to examine the experience of nurses in a Newborn ICU as they used clinical information systems and other medical and information technology in their work. A variety of sources were utilized for data collection, including field observations, a review of on-line and paper documents, a survey of the physical environment and interviews with nurses. The nursing and health care information systems literature was reviewed to enhance the understanding of the current knowledge of how nurses use IT. Social action theories, including structuration theory provided the main theoretical framework. Nurses clearly have adapted information technology into their work world. Nurses, as social actors are able to demonstrate sense making and structuration with and without the use of the available IT. These structures provide order and routines that help the nurse to rapidly make sense of the continuous barrage of sensory input that she is faced with. This is important in a hospital critical care unit, where the time available for “sense making” is limited, and a delay of minutes or even a few seconds can affect a patient's outcome. The structures provide a frame for the nurse's world so that sense making can occur efficiently and effectively. These sense making activities are critical to the nurse successfully accomplishing her work.