Background
Clinical decision support systems (CDSS) for nursing staffs
A need for pain management
Pain management decision support systems (PM-DSS)
A need for understanding the acceptance of clinical decision support systems
Methods
Theoretical foundations
Theoretical framework
Instrument and subjects
Item no. | Item description |
---|---|
1.SQ1 | The PM-DSS is stable. |
2.SQ2 | The response time of PM-DSS is speedy. |
3.SQ3 | The data accessibility of PM-DSS is good. |
4.SQ4 | The effectiveness of PM-DSS security to prevent unauthorized access to patient data. |
5.IQ1 | The PM-DSS can integrate data from different sources. |
6.IQ2 | The information of PM-DSS is accurate. |
7.IQ3 | The content and its display format of PM-DSS can fulfill user needs. |
8.IQ4 | The information of PM-DSS is up-to-date. |
9.IN1 | If I heard that a new technology was available, I would be interested enough to test. |
10.IN2 | I prefer to use the most advanced technology available. |
11.IN3 | In general, I hesitate to try new information system. |
12.CS1 | I could complete the job using PM-DSS if I had never used a system like it before. |
13.CS2 | I could complete the job using PM-DSS if I had used similar system before PAIN MANAGEMENT DSS one to do the same job. |
14.CS3 | I have the ability to operate PM-DSS. |
15.CS4 | I prefer to use a PM-DSS for patient visit. |
16.OS1 | The employee should follow the clinical standard of procedures to complete clinical practice. |
17.OS2 | The employee could share his opinions with the supervisors and participate the decision processes in the pain management. |
18.OS3 | The duties and rights for the pain management were clarified in the work field and all were documented. |
19.OS4 | Greater degree of coordination achieved by grouping all those working on the pain management. |
20.OS5 | The clinical consultation problems would be resolved by many different ways. |
21.OS6 | There were champions for development of the PM-DSS. |
22.OE1 | The adoption of information technology in the hospital, which you serve, will be affected by medical policies. |
23.OE2 | The degree of competition among local hospitals is high. |
24.OE3 | The degree of computerization in our hospitals is high. |
25.OE4 | The requirement of patient care quality is high. |
26.OE5 | The organization provides enough funds to support the adoption of PM-DSS. |
27.PU1 | Using PM-DSS can reduce hospital patient care costs. |
28.PU2 | Using PM-DSS can improve work efficiency. |
29.PU3 | Using PM-DSS can improve patient care quality. |
30.PU4 | Using PM-DSS is helpful in assisting the collection and analyze of patient data. |
31.PU5 | Using PM-DSS can reduce the amount of time in paper work through PM-DSS. |
32.PU6 | Using PM-DSS can improve communication between physicians and hospital staff. |
33.PU7 | Using PM-DSS can improve patient safety. |
34.PU8 | Overall, PM-DSS is helpful in patient pain management. |
35.PE1 | Learning to use PM-DSS would be easy for me. |
36.PE2 | It would be easy for me to become skillful at using PM-DSS. |
37.PE3 | I would find it easy to get PM-DSS to do what I want it to do. |
38.PA1 | I am very satisfied with PM-DSS. |
39.PA2 | The PM-DSS functions perform as expected. |
Ethical considerations
Data analysis
Results
Demographic data
Measure | Category | No(#) | Percent (%) |
---|---|---|---|
Age | <30 | 7 | 6.9 |
31-35 | 50 | 49.5 | |
36-40 | 27 | 26.7 | |
41-45 | 7 | 6.9 | |
46-50 | 9 | 9.0 | |
>50 | 1 | 1.0 | |
Education level | Bachelor | 91 | 91 |
Master | 9 | 9.0 | |
Years of experience in clinical practice | <2 | 0 | 0.0 |
2-5 | 7 | 6.9 | |
5-10 | 34 | 33.6 | |
>10 | 50 | 49.5 | |
Years of experience in using HIS | <2 | 0 | 0.0 |
2-5 | 2 | 2.0 | |
5-10 | 49 | 48.5 | |
>10 | 50 | 49.5 | |
Experience in using PM-DSS | 3-6 Months | 60 | 59.4 |
6-9 Months | 20 | 19.8 | |
9-12Months | 10 | 10.0 | |
>12Months | 11 | 10.8 |
Measurement model
Correlation matrix | AVE (≥0.5) | CR (≥0.7) | Cronbach’s α (≥0.7) | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Mean | SD | SQ | IQ | IN | CS | OS | OE | PU | PE | PA | ||||
SQ |
3.643
|
0.688
| 1.000 | 0.743 | 0.930 | 0.885 | ||||||||
IQ |
3.665
|
0.654
| 0.644* | 1.000 | 0.660 | 0.884 | 0.824 | |||||||
IN |
3.392
|
0.392
| 0.387* | 0.296* | 1.000* | 0.670 | 0.853 | 0.772 | ||||||
CS |
3.677
|
0.619
| 0.372* | 0.413* | 0.728* | 1.000 | 0.710 | 0.910 | 0.870 | |||||
OS |
3.583
|
0.576
| 0.485* | 0.519* | 0.290* | 0.344* | 1.000 | 0.567 | 0.886 | 0.844 | ||||
OE |
3.573
|
0.488
| 0.330* | 0.421* | 0.144* | 0.315* | 0.611* | 1.000 | 0.501 | 0.810 | 0.715 | |||
PU |
3.733
|
0.594
| 0.728* | 0.726* | 0.358* | 0.540* | 0.584* | 0.468* | 1.000 | 0.610 | 0.923 | 0.905 | ||
PE |
3.738
|
0.608
| 0.501* | 0.572* | 0.490* | 0.547* | 0.439* | 0.364* | 0.653* | 1.000 | 0.821 | 0.932 | 0.891 | |
PA |
3.568
|
0.607
| 0.501* | 0.620* | 0.385* | 0.545* | 0.530* | 0.401* | 0.728* | 0.725* | 1.000 | 0.925 | 0.961 | 0.919 |
Hypothesis testing
Hypothsis | Path coefficient | Result |
---|---|---|
H1: IS factors have a significant impact on nurse anesthetists’ perceived PM-DSS usefulness. |
Partial support
| |
H1a: The system quality of the PM-DSS affects nurse anesthetists’ perceived PM-DSS usefulness. | 0.082 | No support |
H1b: PM-DSS information quality affects nurse anesthetists’ perceived PM-DSS usefulness |
0.451***
|
Support
|
H2: IS factors have a significant impact on nurse anesthetists’ perceived PM-DSS usefulness. |
Partial support
| |
H2a: The system quality of the PM-DSS affects nurse anesthetists’ perceived PM-DSS ease of use. | 0.099 | No support |
H2b: PM-DSS information quality affects nurse anesthetists’ perceived PM-DSS ease of use. |
0.267*
|
Support
|
H3: Human factors significantly affect nurse anesthetists’ perceived PM-DSS usefulness. |
Partial support
| |
H3a: Computer self-efficacy affects nurse anesthetists’ perceived PM-DSS usefulness. |
0.315**
|
Support
|
H3b: Personal innovativeness affects nurse anesthetists’ perceived PM-DSS usefulness. | 0.102 | No support |
H4: Human factors significantly affect nurse anesthetists’ perceived PM-DSS ease of use. | No support | |
H4a: Computer self-efficacy affects nurse anesthetists’ perceived PM-DSS ease of use. | 0.191 | No support |
H4b: Personal innovativeness affects nurse anesthetists’ perceived PM-DSS ease of use. | 0.188 | No support |
H5: Organizational factors significantly affect nurse anesthetists’ perceived PM-DSS usefulness. |
Partial support
| |
H5a: Organizational structure affects nurse anesthetists’ perceived PM-DSS usefulness. |
0.210*
|
Support
|
H5b: The organizational affects nurse anesthetists’ perceived PM-DSS usefulness. | 0.041 | No support |
H6: Organizational factors significantly affect nurse anesthetists’ perceived PM-DSS ease of use. | No support | |
H6a: Organizational structure affects nurse anesthetists’ perceived PM-DSS ease of use. | 0.066 | No support |
H6b: The organizational affects nurse anesthetists’ perceived PM-DSS ease of use. | 0.063 | No support |
H7: Nurse anesthetists’ perceived PM-DSS ease of use affects system acceptance. |
0.436***
|
Support
|
H8: Nurse anesthetists’ perceived PM-DSS usefulness of PMDSS affects system acceptance. |
0.443***
|
Support
|