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Impact of using data from electronic protocols in nursing performance management: a qualitative interview study.

Hope, J., Griffiths, P., Schmidt, P.E., Recio-Saucedo, A. and Smith, G. B., 2019. Impact of using data from electronic protocols in nursing performance management: a qualitative interview study. Journal of Nursing Management, 27 (8), 1682-1690.

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DOI: 10.1111/jonm.12858


AIM: To explore the impact of using electronic data in performance management to improve nursing compliance with a protocol. BACKGROUND: Electronic data is increasingly used to monitor protocol compliance but little is known about the impact on nurses' practice in hospital wards. METHOD: Seventeen acute hospital nursing staff participated in semi-structured interviews about compliance with an early warning score (EWS) protocol delivered by a bedside electronic handheld device. RESULTS: Before electronic EWS data was used to monitor compliance, staff combined protocol-led actions with clinical judgement. However, some observations were missed to reduce noise and disruption at night. After compliance monitoring was introduced, observations were sometimes covertly omitted using a loophole. Interviewees described a loss of autonomy but acknowledged the EWS system sometimes flagged unexpected patient deterioration. CONCLUSIONS: Introducing automated electronic systems to support nursing tasks can decrease nursing burden but remove the ability to record legitimate reasons for missing observations. This can result in covert resistance that could reduce patient safety. IMPLICATIONS FOR NURSING MANAGEMENT: Providing the ability to log legitimate reasons for missing observations would allow nurses to balance professional judgement with the use of electronic data in performance management of protocol compliance. This article is protected by copyright. All rights reserved.

Item Type:Article
Additional Information:The research was funded by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care Wessex at Portsmouth Hospitals NHS Trust. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.
Uncontrolled Keywords:Early Warning Score ; Information Management and Technology ; Nursing quality ; Patient safety ; Performance management
Group:Faculty of Health & Social Sciences
ID Code:32742
Deposited By: Symplectic RT2
Deposited On:09 Sep 2019 11:02
Last Modified:14 Mar 2022 14:17


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