title: Impact of Healthcare Information Technology on Nursing Practice.
abstract: OBJECTIVE
  To report additional mediation findings from a descriptive cross sectional study to examine if nurses' perceptions of the impact of healthcare information technology on their practice mediates the relationship between electronic nursing care reminder use and missed nursing care.
  
  
  METHODS
  The study used a descriptive design. The sample (N = 165) was composed of registered nurses working on acute care hospital units. The sample was obtained from a large teaching hospital in Southeast Michigan in the fall of 2012. All eligible nursing units (n = 19) were included.
  
  
  METHODS
  The MISSCARE Survey, Nursing Care Reminders Usage Survey, and the Impact of Healthcare Information Technology Scale were used to collect data to test for mediation. Mediation was tested using the method described by Baron and Kenny. Multiple regression equations were used to analyze the data to determine if mediation occurred between the variables.
  
  
  RESULTS
  Missed nursing care, the outcome variable, was regressed on the predictor variable, reminder usage, and the mediator variable impact of technology on nursing practice. The impact of healthcare information technology (IHIT) on nursing practice negatively affected missed nursing care (t = -4.12, p < .001), explaining 9.8% of variance in missed nursing care. With IHIT present, the predictor (reminder usage) was no longer significant (t = -.70, p = .48). Thus, the reduced direct association between reminder usage and missed nursing care when IHIT was in the model supported the hypothesis that IHIT was at least one of the mediators in the relationship between reminder usage and missed nursing care.
  
  
  CONCLUSIONS
  The perceptions of the impact of healthcare information technology mediates the relationship between nursing care reminder use and missed nursing care. The findings are beneficial to the advancement of healthcare technology in that designers of healthcare information technology systems need to keep in mind that perceptions regarding impacts of the technology will influence usage.
  
  
  CONCLUSIONS
  Many times, information technology systems are not designed to match the workflow of nurses. Systems built with redundant or impertinent reminders may be ignored. System designers must study which reminders nurses find most useful and which reminders result in the best quality outcomes.
authors.affiliation: Theta Psi, Assistant Professor, Wayne State University College of Nursing, Detroit, MI.
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Piscotty
authors.affiliation: Rho, Titus Professor, University of Michigan School of Nursing, Ann Arbor, MI.
authors.forename: Beatrice
authors.initials: B
authors.lastname: Kalisch
authors.affiliation: Theta Psi, Research Assistant, Wayne State University College of Nursing, Detroit, MI.
authors.forename: Angel
authors.initials: A
authors.lastname: Gracey-Thomas
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001292:Attitude to Computers; D003430:Cross-Sectional Studies; D020000:Decision Support Systems, Clinical; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D019300:Medical Errors / Q000517:prevention & control; D009741:Nursing Staff, Hospital; D017010:Reminder Systems / Q000592:standards* / Q000706:statistics & numerical data
keywords: Clinical decision support; missed care; nursing; reminders