護理人員對護理紀錄電子化資訊系統之接受度與系統使用成效之相關性探討-以某精神專科醫院為例

Exploring the Correlation between Acceptance and Effectiveness of Nursing Records Computerization Information System among Nursing Staff- The Case of a Mental Hospital.

高鳳蘭(Feng-Lan Gao)

指導教授 ： 陳金淵

長榮大學/健康科學學院/醫務管理學系(所)/碩士(2015年)

https://doi.org/10.6833/CJCU.2015.00013

摘要

目的 護理記錄電子化是應用資訊科技於臨床護理實務的創新護理作業模式。為降低現有的人力負荷、增加工作效率、提升服務品質，因此醫院開始導入護理記錄電子化的經營管理策略。本研究以整合性科技接受模型為基礎，探討護理人員對護理記錄電子化的接受度及使用成效間之關係，以提供醫院日後改善或其它醫院推動電子病歷系統時之參考。
方法 本研究採橫斷式設計，以南部某精神專科教學醫院的急性、復健及日間病房之120位護理人員為研究對象。以自擬結構性問卷、回溯性病歷審查法與利用護理資訊系統內以VB.net 程式開發之計時器進行資料收集。問卷內容包含個人基本資料、科技接受度量表。共發放問卷120份，回收112份，有效問卷共106份（有效回收率94.6%）。資料整理後，除了描述性統計、獨立樣本t檢定、單因子變異數分析、成對樣本t檢定外，並利用階層迴歸分析檢測護理記錄電子化接受度與使用成效間的關係。
結果 影響護理人員對電子化系統之行為意圖為認知有用性（p<0.001）、主管支持（p<0.001），但不受認知易用性影響。認知易用性（p<0.000）、主管支持（p<0.000）會直接影響認知有用性；主觀減少記錄時間則會受到認知有用性（p=0.002）的影響，而客觀減少記錄時間會受到主管支持（p=0.043）的影響；在記錄時間上線前後有統計上顯著差異（p值＜0.05），且明顯縮短記錄時間。記錄完整性上線前後亦有統計上顯著差異（p＜0.05），且提升完整性；干擾變數交互作用項（認知有用性*不同年資、認知易用性*有無經驗）對行為意圖有顯著的影響，顯示在不同年資及經驗上會有不同的效應。
結論 認知有用性、主管支持會影響護理人員對護理記錄電子化系統的使用成效：有效縮短記錄時間，且記錄完整性優於手寫記錄。因此，當醫院推動電子化記錄系統時，除了要讓護理人員感受到系統的有用性及單位主管的支持性，也要設計簡單易學的操作介面，以提升使用意願，達到電子化系統的目的－降低現有的人力負荷、增加工作效率、提升服務品質。

關鍵字: 護理記錄電子化資訊系統、整合性科技接受模型、使用成效

關鍵字

護理記錄電子化資訊系統 ； 整合性科技接受模型 ； 使用成效

並列摘要

Purpose Nursing records computerization is an innovative nursing practice model, which is an application of information technology used in clinical care nursing practice. In order to reducing the load of human efforts and improving working efficiency and service quality, hospital began to bring in the management strategy of nursing records computerization. The purpose of this study was to integrate the Unified Theory of Acceptance and Use of Technology (UTAUT) model theory to discuss the effect between acceptance and usage of nursing records computerization for providing as a reference to other hospital improving or advancing electronic recording system.
Methods This was a cross-sectional study of 120 cases, sampling from nurses employed at acute psychiatric ward, rehabilitation ward and daycare ward in one of psychiatric teaching hospitals in south Taiwan. A self-designed, structured
questionnaire and the review of retrospective medical record were adopted along with timekeeper developed by VB.net program from nursing information system to conduct data collection. The questionnaire contains basic personal information and Technology Acceptance Scale. A total of 120 questionnaires were administered, 112 were returned, and 106 valid questionnaires were remained (effective rate was 94.6%). In addition to descriptive statistics, independent sample t test, one-way ANOVA and paired sample t test, hierarchical regression analysis also used to detect the relationship between acceptance and usage of nursing records computerization.
Results The result of this study revealed that the factors influencing the behavior of nurses towards computerization system were the perceived usefulness (p <0.001) and supervisor support (p <0.001), but the perceived ease of use. Perceived ease of use (p <0.000) and supervisor support (p <0.000) will directly affect the perceived usefulness. Subjectively reducing the recording time will be influenced by perceived usefulness (p = 0.002), while objectively reducing recording time will be influenced by supervisor support (p = 0.043). It had significant difference before and after the application of electric recording system (p <0.05); the time of recording was shorten obviously. Also, the completeness of recordings had significant difference before and after the application of electric recording system (p <0.05), the completeness was improved. It had a significant effect toward behavioral intentions, after the cross action of moderators (perceived usefulness * seniority difference) and (perceived ease of use * experience); it showed various effects between seniority difference and experience.
Conclusion Perceived usefulness and supervisor support do affect nurses’ usage toward nursing recording computerization: Shorten recording time; the completeness of electric recording is better than hand writing, and improving recording quality. Therefore, when hospital promotes electric recording system, it is not only needed to make nurses feel useful to use the system, but also supervisors give their support on it. Moreover, to design and make the system easy to learn will enhance the desire of use to achieving the purpose of computerization system - reducing the load of human efforts and improving working efficiency and service quality.

Keywords: nursing records computerization information systems, integrated
technology acceptance model, usage effectiveness

並列關鍵字

nursing records computerization information systems ； integrated technology acceptance model ； usage effectiveness

參考文獻

王嵩竑（2008）。護理人員對無線射頻辨識系統接受度模式建構與比較分析：知覺創新特性與科技接受模式觀點。元培學報，15，47-80。

吳明隆（2003）。SPSS統計應用學習實務：問卷分析與應用統計。台北：知城數位科技股份有限公司。

吳淑靜、黃蔚仁、孫吉珍、谷幼雄、朱唯勤（2010）。導入資訊化給藥作業系統對於護理人員接受度之影響因子的初步分析。志為護理-慈濟護理雜誌，9(5)，71-79。

宋鎧 等編著（2001）。管理資訊系統 。 台北：華泰文化事業股份有限公司。

李亭亭、施玉珊（2009）。運用創新擴散理論於促進護理資訊系統之推展。護理雜誌，56(3)，18-22。