以質性研究法探討護理人員面對護理資訊系統中斷的處理經驗

The Experience of Nurses Dealing with Dysfunctional Nursing Information Systems: A Qualitative Study

電腦資訊是現今不可或缺的工具之一，醫療院所已將無線網路科技應用導入各項醫療作業及護理領域，臨床工作中發現資訊系統推行後，護理人員逐漸依賴護理資訊系統，一旦資訊系統中斷，可能造成臨床護理人員在照顧病人時，無法立即給予護理處置而影響病人安全。本研究之目的為透過質性訪談探討在醫院工作的護理人員面對護理資訊系統中斷之處理經驗，採立意取樣方式，以半結構式的訪談方法，收集中部某醫學中心具有處理護理資訊系統中斷經驗的20位護理師的經驗。訪談結果轉錄為逐字稿後，以質性內容分析法進行資料分析。結果歸納出5個主題及15個次主題：（1）延長工時：等待、作業時間延長、重複工時；（2）互助合作：資訊師的協助、同儕互助、協助醫師致事情做不完；（3）工作重整：重要且緊急的先做、以紙本先作業、先做其他不須使用資訊系統事務；（4）影響工作情緒：工作不順、來自病人及家屬的壓力、與資訊人員的衝突；（5）對護理資訊系統的依賴：習慣資訊化、對紙本作業不熟悉、擔心新進護理師不會處理。研究結果期望能夠提供護理人員面對資訊系統中斷的因應參考。

Computer science has become one of the indispensable tools and the healthcare institutes have implemented wireless network into medical and nursing care. After the clinical care information system was implied, nurses have become more and more dependent on the nursing information system. Once the system disconnected, nurses become difficult to provide properly nursing intervention and may affect patients' safety. The purpose of this study was to reveal the nurses' experience of dealing with dysfunctional nursing information system by using qualitative research. The purposive sampling was adopted, and the registered nurses had experience of dealing with the dysfunctional information system were chosen as potential participants. Consequently, 20 nurses were in-depth interviewed by the first author in a medical center in central Taiwan. The interview data were transcribed into verbatim and analyzed by content analysis. The results were summarized in 5 themes and 15 categories: (1) Extending working hours: waiting time extended, working time extended, duplicate working hours; (2) Mutual cooperation: assistance from information technology staff, mutual help, assist doctors lead to less time for nurses; (3) Reorganizing to do list: important and urgent things first, paperwork first, non-computer tasks first; (4) Affecting working emotions: workflow is not smoothy, stress from patients and their families, conflict with information technology staff; (5) Dependence on nursing information systems: getting used to information-based nursing, being unfamiliar with paperwork, being worried that new nurses may fail to deal with the situations. The results of the study provide references for the management of dysfunctional nursing information.