Evaluation of Knowledge and Attitude of Nurses to Information Technology on Nursing Care Delivery in Enugu Metropolis
CHAPTER ONE
OBJECTIVE OF THE STUDY
The motivation behind this study are
- To determine the current levels of knowledge of information and communication technology among Nurses in Enugu.
- To determine Nurses understanding of the relevance of ICT to Nursing care delivery.
- To ascertain the level of usage of ICT among Nurses in Enugu.
CHAPTER TWO
LITERATURE REVIEW
Introduction
“In this age of technology, where you can simulate or manipulate anything, how do we retain that human element?” Dave Grohl
The purpose of this literature review is to explore the scope of competence necessary for the use of information and communication technology (ICT) in nursing care. The study question of what competence is required from nurses for the use of information and communication technology (ICT) in nursing care is its main reference point.
The usage of ICT has steadily increased in all life spheres, including economic, social, political and cultural (OECD 2009: 13-14), as well as health care, caring science and nursing. The gradual introduction and further extensive utilization of such technological inventions as personal computer, cell phone and Internet has impacted every aspect of life (OECD 2009: 13-14), making it unimaginable to provide services or even function without them. In the health care sector, especially with the recent general shift to outpatient care, ICT usage has become essential in decentralized health care provision (Thomassen & Jansen 2013: 58). However, since the introduction of digital technology into health care, nurses have been often in opposition, claiming that use of computerized systems prevents them from capturing “the real nursing” (Darbyshire 2004), distances nurses from patients (O’Keefe-McCarthy 2009: 794) and disrupts the rapport (Adams et al. 2007). Multiple technical problems also negatively affect the acceptance of new technologies. One reason for this might be that the ICT based systems used in health care are seldom designed with nurses’ active participation and thus it may seem that the nurses are serving the system, not the system serves the nurses’ needs.
In the digital era, when ICT rapidly starts to dominate every aspect of life, the question is not whether to transfer nursing practice to the digital world to meet the patients’ needs as well as economic constraints and demands. The question is how to do it. How do we provide high quality nursing care in the digital world? How do we assure our patients that they interact with another human being, not with a machine? How do we retain that human element?
CONCEPTUAL REVIEW
Concept of Knowledge
According to the New International Websters Comprehensive Dictionary of English Language (2013), knowledge is a result or product of knowing, information or understanding acquired through experience, practical ability or skill.
Knowledge can be acquired in three different dormains namely: cognitive, affective and psychomotor learning. Craven & Hirnle (2006) stated that cognitive knowledge is the rational thought and involves learning about facts, arriving at a conclusion, making decisions or drawing inferences. Affective learning result in changed beliefs, attitudes or values while psychomotor refers to muscular movements that form some sort of knowledge.
Knowledge of patient teaching: As documented by Berman et. al, (2012) knowledge alone is not enough to motivate a person to change behaviour. There is need to learn what needs to be done to change behaviours and acting on the knowledge. Therefore, knowledge must appeal to the emotion for it to affect behaviour. This is because emotion works hand-in-hand with cognitive process or the way we think about an issue or situation. Patient teaching involves means whereby attitudes counter- productive to health and wellbeing might have to be altered. For patient teaching to be effective it must meet the needs expressed by the individual clients themselves.
CHAPTER THREE
RESEARCH METHODOLOGY
Research Design
A descriptive research design will be utilized in this study. This design is concerned with description of phenomena of interest and focuses on a single group or population characteristics, attributes, and/or experiences (Schmidt & Brown, 2012).
AREA OF STUDY
Enugu, usually referred to as Enugu State to distinguish it from the city of Enugu, is a state in Southeastern Nigeria, created in 1991 from part of the old Anambra State. Its capital and largest city is Enugu, from which the state derives its name, the principal cities in the state are Enugu, Ngwo, Agbani and Aw
Subjects
A Convenient sample of all nurses working university of Nigeria teaching hospital Enugu, ESUT teaching hospital (parklane) enugu, national orthopedic hospital Enugu, annunciation hospital and royal hospital Enugu. (57357) were interviewed for were the study sample for three months .The total number of nurses (100) nurses from them were working at out-patient clinics. Through the three shifts (morning and night shifts) for three months who were willing to participate in the study.
Tools
To achieve the purpose of the study, data will be collected using two tools developed by investigator.
Socio-demographic data sheet:
It consists of two main sections:
- Socio-demographic data: It includes data related to: code No, gender, age, marital status, level of education, department of working and years of experience in and out hospital.
- Questions related to assessment of nurses’ knowledge related to information technology: It cover data regarding basic knowledge of computer skills, benefits from information technology, idea about nursing informatics, English language before and after using computers.
Nurses’ practices assessment:
Include items related to the nurse’s practices toward information technology such as laptop, touch screen and power cord, the barriers to nurses being to enter client data into EMR (electronic medical record) etc, the total scores of this sheet are 100%.
The scoring system classified as following:
Unsatisfactory level of Practice: less than 75% Satisfactory level of Practice: Between 75% and 90% Good Practice: more than 90%.
CHAPTER FOUR
RESULTS AND DISCUSSIONS
Results
Table 1: showed that the majority of the studied sample were females and while specialized nurse, where their ages ranged between 20-<30 years; (81.1%), (92.2%) and (84.4%) respectively. As well more than half of them living in urban area (60%) they were graduated of faculty of nursing (66.7%). Less than half of them (40%) are having < 5 years of working experiences outside and inside hospital. (37.5%) of nurses were working in ground floor out-patient clinics and they are having 3-5 years of working experiences inside hospital (35.6%).
Table 2: showed that the majority of the studied subjects answered (Improve) knowledge questions .Furthermore, the majority of the studied sample had good knowledge according to patient care through nursing informatics system with percentage (equal 100 %).
Figure 1: showed that the majority of studied sample (98%) knowledge score level according to nursing informatics system was good. While (1%) and (1%) of studied sample had satisfactory and unsatisfactory respectively.
Table 3: showed that the majority of the studied sample was satisfactory practice of nursing informatics system according to results in this table. The majority of nurses’ access to computer on your unit easily and nurses had experienced computer as user. In addition to, nurses enter data into the electronic medical record, and do you feel confident about what you are doing (96.7%), (77.8%) and (94.4%) respectively.
Figure 2: showed that more than half of nurses (62%) practices score level according to nursing informatics system was satisfactory. While (34.4%) of nurses were unsatisfactory of practice. furthermore, (3%) of nurses were good of practice.
Table 4: showed that the majority of nurses answered strongly agree and agree in attitude questions. Furthermore, the majority of nurses had positive attitude according to nursing informatics system improved the ability to give patient rights with percentage (equal 81.1 %).
Figure 3: showed that the majority of studied sample (77%) attitude score level according to nursing informatics system was good (positive attitude). While (23%) of studied sample was satisfactory.
Table 5: showed that there was no statistical correlation between total nurse’s attitude of nursing informatics system according to total practice of nursing informatics system (r=.125, P=.242). While, there was no statistical correlation between total knowledge of nursing informatics system according to total practice and total attitude of nursing informatics system (r=.319) and (r=.334) respectively. Furthermore, there was highly statistical significant difference between total knowledge of nursing informatics system according to total practice and total attitude of nursing informatics system (P=.003) and (P=.002) respectively.
Discussion
Current research can be considered as giving some insight, but an incomplete picture of nursing informatics system implementation in nursing field. Nevertheless, evolution both in nursing informatics system theoretical approaches and evaluation research has opened a new road for a more comprehensive analysis of nursing informatics system implementation (Roger Watson, 2012). The total number of the studied sample was (90) nurses, the three quarters of them were females that might be through the greater fraction of the nurses in university of Nigeria teaching hospital Enugu, ESUT teaching hospital (parklane) Enugu, national orthopaedic hospital Enugu, annunciation hospital and royal hospital Enugu was exclusive for females only till seven years ago; where their ages ranged between 20-<30 years. Thus, half or more of them were single and had Bachelor nursing degree lead to less than half of them are having < 5 years of working experiences inside and outside hospital. In researcher point of view a lot of bachelor nurses prefer to work at private hospitals and travel abroad they have better chances than diploma nurses .Therefore, bedside nurses in governmental hospitals were diploma nurses and when the bachelor nurses work in the governmental hospitals they are working as a head nurses not a bedside nurse. As well, more than half of them living in city and more one third of them working in ground floor at out-patient clinics.
CHAPTER FIVE
Conclusion and recommendations
The current study concluded that, nurses are responsible for a substantial part of the patient record and hence are particularly affected by the computerization. The appliance of Information Systems into nursing provides important advantages in the administration of the nursing personnel’s data, contributing to the improvement of the operating effectiveness of the Nursing Service (Malliarou et al., 2008). The use of nursing informatics system (NIS) has increased completeness of some nursing documentation elements. Also, the current study recommended that there is great variability among nursing schools and curricula. Professional skills learned and opportunities for employment are dependent on the quality and level of the educational programs. Proficiency in decision making and acquisition of technical competence to face new challenges are the major areas that must be improved in the nursing education curricula.
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