title: Nurses' Clinical Decision Making on Adopting a Wound Clinical Decision Support System.
abstract: Healthcare information technology systems are considered the ideal tool to inculcate evidence-based nursing practices. The wound clinical decision support system was built locally to support nurses to manage pressure ulcer wounds in their daily practice. However, its adoption rate is not optimal. The study's objective was to discover the concepts that informed the RNs' decisions to adopt the wound clinical decision support system as an evidence-based technology in their nursing practice. This was an exploratory, descriptive, and qualitative design using face-to-face interviews, individual interviews, and active participatory observation. A purposive, theoretical sample of 14 RNs was recruited from one of the largest public tertiary hospitals in Singapore after obtaining ethics approval. After consenting, the nurses were interviewed and observed separately. Recruitment stopped when data saturation was reached. All transcribed interview data underwent a concurrent thematic analysis, whereas observational data were content analyzed independently and subsequently triangulated with the interview data. Eight emerging themes were identified, namely, use of the wound clinical decision support system, beliefs in the wound clinical decision support system, influences of the workplace culture, extent of the benefits, professional control over nursing practices, use of knowledge, gut feelings, and emotions (fear, doubt, and frustration). These themes represented the nurses' mental outlook as they made decisions on adopting the wound clinical decision support system in light of the complexities of their roles and workloads. This research has provided insight on the nurses' thoughts regarding their decision to interact with the computer environment in a Singapore context. It captured the nurses' complex thoughts when deciding whether to adopt or reject information technology as they practice in a clinical setting.
authors.affiliation: Author Affiliations: Tan Tock Seng Hospital Pte Ltd (Ms Khong and Ms Hoi), Singapore; Asian and Gender Nursing, School of Health Sciences, RMIT University, Bundoora, Victoria, Melbourne (Prof Holroyd); and Yong Loo Lin School of Medicine, Alice Lee Centre for Nursing Studies, National University Singapore (Prof Holroyd and Dr Wang).
authors.forename: Peck Chui Betty
authors.initials: PC
authors.lastname: Khong
authors.forename: Shu Yin
authors.initials: SY
authors.lastname: Hoi
authors.forename: Eleanor
authors.initials: E
authors.lastname: Holroyd
authors.forename: Wenru
authors.initials: W
authors.lastname: Wang
mesh_terms: D000328:Adult; D002983:Clinical Competence; D000066491:Clinical Decision-Making; D003657:Decision Making; D020000:Decision Support Systems, Clinical; D055318:Evidence-Based Nursing; D005260:Female; D063005:Health Information Systems; D006801:Humans; D008297:Male; D008875:Middle Aged; D048108:Nursing Informatics; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000523:psychology*; D003668:Pressure Ulcer / Q000628:therapy; D036301:Qualitative Research