title: [Identifying Usability Level and Factors Affecting Electronic Nursing Record Systems: A Multi-institutional Time-motion Approach].
abstract: OBJECTIVE
  The usability, user satisfaction, and impact of electronic nursing record (ENR) systems were investigated.
  
  
  METHODS
  This mixed-method research was performed as a time-motion (TM) study and a survey which were carried out at six hospitals between August and November 2013. The TM study involved 108 nurses from medical, surgical, and intensive care units at each hospital, plus an additional 48 nurses who served as nonparticipating observers. In the survey, 1879 volunteer nurses completed the Impact of ENR Systems Scale, the System Usability Scale, and a global satisfaction scale. Qualitative and quantitative analyses were performed.
  
  
  RESULTS
  The mean scores for the ENR impact, system usability, and satisfaction were 4.28 (out of 6), 58.62 (out of 100), and 74.31 (out of 100), respectively, and they differed significantly between hospitals (F=43.43, p<.001, F=53.08 and p<.001, and F=29.13 and p<.001, respectively). A workflow fragmentation assessment revealed different patterns of ENR system use among the included hospitals. Three user characteristics-educational background, practice period, and experience of using paper records-significantly affected the system usability and satisfaction scores.
  
  
  CONCLUSIONS
  The system quality varied widely among the ENR systems. The generally low-to-moderate levels of system usability and user satisfaction suggest many opportunities for improvement.
authors.affiliation: Department of Nursing, Inha University, Incheon, Korea. insook.cho@inha.ac.kr.
authors.forename: Insook
authors.initials: I
authors.lastname: Cho
authors.affiliation: Department of Nursing, SMG-SNU Boramae Medical Center, Seoul, Korea.
authors.forename: Won Ja
authors.initials: WJ
authors.lastname: Choi
authors.affiliation: Department of Nursing, Seoul National University Hospital, Seoul, Korea.
authors.forename: Woanheui
authors.initials: W
authors.lastname: Choi
authors.affiliation: Department of Nursing, Dongguk University Ilsan Hospital, Goyang, Korea.
authors.forename: Misuk
authors.initials: M
authors.lastname: Hyun
authors.affiliation: Department of Nursing, Ajou University Hospital, Suwon, Korea.
authors.forename: Yeonok
authors.initials: Y
authors.lastname: Park
authors.affiliation: Department of Nursing, Korea University Guro Hospital, Seoul, Korea.
authors.forename: Yoona
authors.initials: Y
authors.lastname: Lee
authors.affiliation: Department of Nursing, Pai Chai University, Daejeon, Korea.
authors.forename: Euiyoung
authors.initials: E
authors.lastname: Cho
authors.affiliation: Department of Nursing, National Cancer Center, Goyang, Korea.
authors.forename: Okhee
authors.initials: O
authors.lastname: Hwang
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D009737:Nursing Records; D009741:Nursing Staff, Hospital / Q000523:psychology*; D010549:Personal Satisfaction; D011795:Surveys and Questionnaires; D014584:User-Computer Interface
keywords: Electronic health records; Nursing records; Time and motion studies; User-computer interface; Work satisfaction