A Qualitative Content Analysis of Nurses’ Comfort and Employment of Workarounds With Electronic Documentation Systems in Home Care Practice

Abstract

Background Electronic documentation systems have the potential to assist registered nurses with timely access to patient health- and care-related information. Registered nurses are the largest users of electronic documentation systems; however, limited evidence exists about their comfort with electronic documentation system usage and the types of workarounds developed within the context of home care. Aim To explore home care registered nurses’ comfort with electronic documentation system usage and identify the types and reasons for the development and implementation of workarounds. Methods A cross-sectional survey design was employed to collect quantitative and qualitative data. A total of 217 home care registered nurses participated in the survey. Quantitative data were analyzed using descriptive statistics. Qualitative data were analyzed using inductive content analysis. Findings: Individual (e.g., registered nurses’ technology-related experience), technological (e.g., electronic documentation system design) and organizational (e.g. training) characteristics influenced registered nurses’ comfort with electronic documentation system usage. Furthermore, workarounds stemmed from the technological characteristics of the electronic documentation system. Conclusion Findings highlight the need for assessing registered nurses’ level of comfort with electronic documentation system usage to inform training initiatives. Including registered nurses in the system design is advocated to ensure electronic documentation systems fit with the complexity of nursing practice, potentially enhancing registered nurses’ level of comfort and mitigating the development and employment of workarounds during system usage.