title: Factors affecting and affected by user acceptance of computer-based nursing documentation: results of a two-year study.
abstract: OBJECTIVE
  The documentation of the nursing process is an important but often neglected part of clinical documentation. Paper-based systems have been introduced to support nursing process documentation. Frequently, however, problems such as low quality of documentation are reported. It is unclear whether computer-based documentation systems can reduce these problems and which factors influence their acceptance by users.
  
  
  METHODS
  We introduced a computer-based nursing documentation system on four wards of the University Hospitals of Heidelberg and systematically evaluated its preconditions and its effects in a pretest-posttest intervention study. For the analysis of user acceptance, we concentrated on subjective data drawn from questionnaires and interviews.
  
  
  METHODS
  A questionnaire was developed using items from published questionnaires and items that had to be developed for the special purpose of this study.
  
  
  RESULTS
  The quantitative results point to two factors influencing the acceptance of a new computer-based documentation system: the previous acceptance of the nursing process and the previous amount of self-confidence when using computers. On one ward, the diverse acceptance scores heavily declined after the introduction of the nursing documentation system. Explorative qualitative analysis on this ward points to further success factors of computer-based nursing documentation systems.
  
  
  CONCLUSIONS
  Our results can be used to assist the planning and introduction of computer-based nursing documentation systems. They demonstrate the importance of computer experience and acceptance of the nursing process on a ward but also point to other factors such as the fit between nursing workflow and the functionality of a nursing documentation system.
authors.affiliation: University for Health Informatics and Technology Tyrol, Innsbruck, Austria. elske.ammenwerth@umit.at
authors.forename: Elske
authors.initials: E
authors.lastname: Ammenwerth
authors.forename: Ulrich
authors.initials: U
authors.lastname: Mansmann
authors.forename: Carola
authors.initials: C
authors.lastname: Iller
authors.forename: Ronald
authors.initials: R
authors.lastname: Eichstädter
mesh_terms: D001291:Attitude of Health Personnel; D001292:Attitude to Computers; D004282:Documentation; D005858:Germany; D006785:Hospitals, University; D006801:Humans; D007407:Interviews as Topic; D016347:Medical Records Systems, Computerized; D015403:Nursing Evaluation Research; D009737:Nursing Records; D009741:Nursing Staff, Hospital / Q000523:psychology; D011795:Surveys and Questionnaires