Table 1 Summary of analyzed articles
Authors | Aims and objectives | Methods design | Interview | Focus group | Observation | Results |
|---|---|---|---|---|---|---|
Data analysis | ||||||
Sample | ||||||
Date of publication | ||||||
Country | ||||||
Title | ||||||
Alexander et al. (2007) U.S.A. Clinical information systems in nursing homes: an evaluation of initial implementation strategies [38] | To explore implementation strategies, employee experiences, and factors influencing employee satisfaction | Explorative 4 nursing homes, 6 months after implementation | 23 | 22 | --- | Five themes emerged: (1) perception and cognition, (2) change, (3) workable system, (4) competence and (5) connectedness. |
Focus groups (22 à 60 Min.) | ||||||
Implementation strategies associated with lower satisfaction were availability of equipment, training resources, and the presence of professional information technology. The experiences differ [according] to the role. | ||||||
Unstructured observations (< 5 min., made when using the technology, (n=?) semi-structured interviews (unknown type) (n=23) axial coding | ||||||
Cherry et al. (2008) U.S.A. Factors affecting electronic health record adoption in long-term care facilities [39] | To gain information about Long Term Care leaders’ general understanding about Electronic Health Records (EHR) and identify factors that hinder and facilitate EHR in Long Term Care | Explorative | --- | 34 | --- | Primary barriers identified were costs, the need for training and the culture of change. Primary facilitators were training programs, well-defined implementation plans, evidence that the electronic systems will improve care outcomes. |
Focus groups (34) via telephone conference call with directors of nursing, Administrators and corporate executives divided into users and non-users | ||||||
Cherry et al. U.S.A. (2011) Experiences with electronic health records: early adopters in long-term care facilities [40] | Providing a description of the early users’ experiences, challenges and benefits with Electronic Health Records in Long Term Care | Explorative | 70 | --- | 10 | The RACF employees who work with EHR systems on a daily basis were positive about their experiences. In particular, operational improvements were achieved through increased access to resident information, cost avoidance, increased documentation accuracy and implementation of evidence-based practices. |
Semi-structured interviews of unknown type, group-observation | ||||||
10 "freestanding" Sites, one-site visit for 6-8 hours per visit with the following schedule for the face-to-face interviews: (a) 60 min for facility tour, (b) 45 min with the administrator, (c) 45 min with the DON, (d) 45 min with a group of assistant DONs and charge nurses, (e) 45 min with a group of direct care staff, (f) 45 min with residents and family members, (g) 60 min for observation on the unit during shift change | ||||||
Munyisia et al. (2012) Australia The impact of an electronic nursing documentation system on efficiency of documentation by caregivers in a residential aged care facility [26] | To examine the effect of the introduction of an Electronic Health Records system on the efficiency in a Long Term Care facility | NOT INCLUDED IN THIS REVIEW: | 8 | --- | --- | Qualitative interviews to gain a better understanding 1. Personal Carers were happy in general because of quicker access and release from referring to written doctors notes |
Longitudinal cohort study | ||||||
INCLUDED IN THIS REVIEW: | ||||||
2. Certain information items were double charted (Paper and EHR) due to organizational reasons | ||||||
Explorative semi-structured Interviews (n=8) unknown type 6 and 12 months after introduction | ||||||
3. It took longer to complete some documentation tasks using a computer (too many clicks to enter data) | ||||||
Qualitative content analysis | 4. Continuous training is needed for some caregivers to effectively use the EHR | |||||
Rantz et al. (2011) U.S.A. The use of a bedside electronic medical record to improve quality of care in nursing facilities: a qualitative analysis [41] | To examine the effect of the introduction of a bedside electronic medical record on the improvement of care in nursing facilities | (Part of the study of Alexander et al.) | 120 | 22 | ? | Communication and information was improved which led to a general improvement of patient care |
Explorative qualitative interviews (n=120), observations (?), focus groups (22) content analysisin all 4 homes 6,12, 18 months after implementation, additional interviews took place (n=?) 24 months after implementation in 2 homes | ||||||
Experience of limited time due to EHR (Direct Carer) vs. saved time (Management) | ||||||
Too much time for operating and managing the system | ||||||
Yu et al. (2008) Australia Caregivers' acceptance of electronic documentation in nursing homes [35] | The aim of the study was to investigate nursing home caregivers' acceptance of electronic documentation | NOT INCLUDED IN THIS REVIEW | 12 | --- | --- | Some staff (4) with low experience wished for more time in the beginning and more instructions |
Some staff (4) often used computers at home felt the software was easy to use | ||||||
Questionnaire survey | Other staff (4) felt they needed more practice than theoretical lessons | |||||
INCLUDED IN THIS REVIEW | ||||||
Semi-structured interviews unknown type after 11 weeks computer-based (n = 12) | ||||||
Paper-based n =? | ||||||
One Home that implemented an Electronic Health Records; one home remained paper-based. | ||||||
Zhang (2012) Australia The benefit of introducing electronic health records in residential aged care facilities: A multiple case study [42] | The aim of this study was to identify the benefits of Electronic Health Record in Long Term Care and to examine how the benefit have been achieved | Explorative semi-structured Interviews (n=110) content analysis, theoretical sampling | 110 | --- | --- | BENEFITS TO THE STAFF |
Convenience and efficiency in data entry, distribution, storage and retrieval | ||||||
Ease of access more information to better understand the residents, the service and peer-learning | ||||||
Empowering care staff | ||||||
BENEFITS TO THE RESIDENTS | ||||||
Improving Quality of Care | ||||||
BENEFITS TO THE RACFs | ||||||
better information management | ||||||
Improving the communication system | ||||||
Improving access to funding facilitating care quality control better work environment educational benefits | ||||||
Data Foundation (at least) // 23 Interviews and 22 focus groups removed due to doubling | 320 | 56 | 10 | |||