以資訊系統成功模式探討護理資訊系統之成效-以某醫學中心為例

背景：醫療院所使用護理資訊系統已逐漸成為常態，護理人員可以透過護理資訊系統迅速取得病人資訊，減少重複紀錄時間，提高工作效率及服務品質等。護理人員為最主要使用者，故系統的實施要考量到護理人員的使用需求、工作滿意度及工作績效等。目的：本研究旨在瞭解護理資訊系統實施之現況，護理人員不同個人特性和工作特質對護理資訊系統成效之差異，並驗證護理資訊系統成功模式，探究相關影響因素。方法：本研究採橫斷式研究設計，採用以資訊系統成功模式（ ISSM）發展出的結構式問卷於2015年4月至5月對南部某醫學中心使用護理資訊系統的護理人員進行資料收集，有效樣本總計1284份，有效回收率達95.32%。以SPSS20.0版及AMOS 22.0套裝軟體運用描述性統計、t-test、ANOVA、Pearson相關及結構方程模式(SEM)進行資料分析。結果：護理人員個人特性中除了年齡對系統使用的意願、使用者滿意度及系統使用效益具有顯著差異(p<.05)。工作特質中工作職稱、服務科別、服務單位對系統使用的意願、使用者滿意度及系統使用效益具有顯著差異(p<.05)。資訊品質、系統品質與服務品質會顯著影響使用意願（β = .202、.468、.235，p < .001）；而系統品質與服務品質會顯著影響使用者滿意度（β = .275、.087，p < .01）及系統使用效益（β = .239、.124，p < .001）；使用意願會顯著影響使用者滿意度及系統使用效益(p < .001）。結論：研究結果發現護理資訊系統成功模式的構面間有顯著正向關係，建議機構管理者於系統開發或設計時，應著重在護理人員的需求，參考人員的意見，注意資訊品質、系統品質、服務品質與系統使用的衡量，才能提升使用者滿意度及系統使用效益，助於整體護理照護品質之效率與效能的提升。

關鍵字

資訊系統成功模式；護理資訊系統

並列摘要

Background: The medical institutions used nursing information systems gradually became as the norm; therefore, nurses could quickly obtain patient data through nursing information system and reduce duplicated recordtime. Those improved work efficiency and service quality etc., Nurses were the most important users of this system; the system implementation should consider about the needs, job satisfactionandjob performance of caregiver. Objective: This study tried to understand the current status about the implementation of nursing information system, due to nurses had individual personality and work characteristics, those factors will cause different outcome of nursing information system. We also verified nursing information systems success model to explore the related factors. Methods: This study used cross - sectionalstudy design,we adopted the information systems to the successful model (ISSM) to develop a structured questionnaire to collect the data from nurseswho were using nursing information systems in the southern medical center from April to May 2015, total of 1284valid samples, the effective recovery rate of 95.32%. Version SPSS20.0 and AMOS 22.0software package, descript statistics, t-test, ANOVA, Pearson correlation and structural equation modeling (SEM) were used to perform data analysis. Results: Within nurses individual personality factors, except age acted a role on willingness to use the system, user satisfaction and system efficiency with a significant difference (p <.05). Among work characteristics, the job title, the service divisions, and serviceunit on willingness to use the system; user satisfaction and system efficiency with a significant difference (p <.05). Information quality, system quality, and service quality significantly affected willingness to use the system (β = .202, .468, .235, p <.001); the system quality and service quality had significant impact on both user satisfaction (β = .275, .087, p <.01) and system efficiency (β = .239, .124, p <.001). Willingness of use the system had significantly affected user satisfaction and system efficiency (p <.001). Conclusion: This study found that among facets of successful models of nursing information systems, they had significant positive relationship. We recommended that when developing or design the nursing information systems, the institution managerial ranking should focus on the needs of the nursing staff, refer to personnel comments, and pay attention to information quality, system quality, service quality and system exercise measurement. Those considerations could promote user satisfaction and system exercise efficiency; and improve the efficiency and effectiveness of the overall quality of nursing care.