Actions affect the acceptance of hospital nursing station Factors - A Case Study of a regional teaching
hospital in southern
The Factors Affecting Hospital Mobile Nursing Station Acceptance:A Case Study of TeachingHospital
Yi-Chun Lin a, Chien Yu-Mei ab, Institutional Factors c
a Information Management, National Chung Cheng University, b Chinese economy, nursing, c Chiayi Chang Gung Nursing
Department
caviar_lin@mis.ccu.edu.tw
Summary
In this study, technology acceptance model to the south all of a teaching hospital inpatient use of the mobile nursing station nurses conducted a questionnaire survey of hospital operations aimed at the user acceptance factors in nursing station. In this study, a total of 185questionnaires were sent and 181 returned, recovery is 97.8%, 165 valid questionnaires, 16 valid questionnaires, the
questionnaire explained 91.2%. In this study, analysis of variance and stepwise regression method of measuring the use of all relevant factors in the relationship between intention. The research results show: (1) affect the intention to use the mobile nursing station as perceived usefulness, system security, and the
perceived ease of use. (2) action by the nursing station factors affecting the sequence, the perceived usefulness and ease of use is still the time of the user acceptance of new technology the most important considerations, and the TAM model assuming full compliance, but most users do not care about the factors were top management support. Results from the study to understand user acceptance of information technology can influence factors, and actions being planned to provide medical care institutions reference stations, to reduce the risk of failure.
Keywords: mobile nursing stations, technology acceptance model Abstract
This research adopted the theory of TAM, to explore the acceptance of using "Mobile Nursing Station"
by all nurses in the in-patient department of a teaching hospital of Chiayi country, Taiwan. This research used case study method and questionnaire survey to collect the first hand information. Totally 185 questionnaires were sent out and 181 returned, therefore the return rate is 97.8%. Among them, there are 165 valid questionnaires and the invalid questionnaires are 16, which make the explanation rate 91.2%. "One-Way ANOVA "and" multiple step-wise regression "were used to analyze the results of this study. The research results show, the influencing factors of users' intention to use the mobile nursing station included the perceived usefulness, the safety issue, and the perceived ease of use of the system. Regarding the sequence of the influencing
Factors, the perceived usefulness and ease of use are most concerned by the user. The least important factor that influences acceptance is the support of the top executives. The results of this study shad some light in the user acceptance of IT in the healthcare industry and provide those hospitals planning for adopting mobile nursing station as reference, to reduce possible risk of adoption failure.
Keywords: Mobile Nursing Station, Technology Acceptance Model.
I. Introduction
The face of socio-economic and health care system of intense change, how to improve the competitiveness of hospital operations and medical service quality is indeed an important subject. Hospitals in the face "to improve competitiveness, reduce operating costs," the pressure, but also have to follow the example
companies, expected by the promotion of information technology into competitive advantage and solve the problem. Mobile nursing station in addition to reducing manual errors, it can also help through electronic and enhance the care for each medical beds, the hospital and then to expand the size or streamlining purposes.
The wireless communications with anytime, anywhere communication features, the correct times of emergency information to increase access to efficient medical practitioners, it is likely that the key to life and death.
In recent years the wireless information technology used in medical research industry is gradually increasing. Such as: wireless networking and mobile technology in health care technology, has developed the use of movable type in the computer device or PDA, combining the wireless network and connect with medical equipment, patient records directly to the physiological measurement data in addition to timely monitor diseases, but also reduce due to the error caused by manual operation, and many more are systems or organizations build research into factors, there is no import of the user for the acceptance of this
technology. However, from the perspective of cognitive psychology, individual internal and external behavior of the cognitive performance of great relevance [Chun-Hsing Chang 6, 1997], therefore, to understand the factors that influence internal cognitive users, and to seek its external control factors, into new technology for organizations, has its relevance and necessity.
In the field of information systems, the use of information technology will affect the actual use but important research topic [Szajna, 1996 25, Davis, 1989a 16, Venkatesh
& Davis, 1996 29]. Therefore, this study is to address the hospital nursing staff for the use of mobile nursing station depth will confirm acceptance of factors
affecting the technology to help hospitals set up mobile nursing station reference.
This research literature review and expert advice at home and abroad, the establishment of research framework, which in some of the user's acceptance will be made by Davis, "Technology Acceptance Model (Technology Acceptance Model; TAM)"
as the theoretical foundation for developing the questionnaire, Taiwan
implementation of mobile nursing stations in the southern region the better the effectiveness of a regional teaching hospital inpatient care for all using a mobile station conducted a questionnaire survey of nurses, their research purposes, such as the following three points: 1) to understand the nursing station for mobile users into the acceptance of ; 2), sorting and analysis on the user acceptance for mobile nursing station elements; 3) of the user acceptance for mobile nursing stations degree of order factors.
Two, the literature
In short, wireless network information to allow one or more links to pass information between devices without the need for physical lines. 而wireless
network application system by radio waves as transmission medium, the
technology used in Yi Liao industry, principally so that medical care Zuoyedadao Xingdong-based electronic,标准化, small and convenient Xing as the target of. In
particular, a large number of medical operations in the human and customer satisfaction and death emergency room and general ward nursing station, is ideal for wireless operation mode [Jane Yi Yi 7, 2001].
Affect the individual information technology (IT) acceptance of a number of factors, Davis to TRA / TPB theory, to quote the user in the MISfield to study the main factors affecting the acceptance of IT, while the proposed TAM, to explain the scope of its application users with the acceptance of new IT, which is chosen
beliefs and attitudes related to the formation, to predict the end-user acceptance [Succi & Walter 26, 1999]. In short, the inner awareness from the user point of view to explain user acceptance of information technology adoption behavior.
Organizations or businesses can use TAM to explain and predict the acceptance of IT, and then control the external factors that enhance the user's acceptance of theIT in order to successfully promote and achieve the ultimate goal of
management. TAM is the most commonly used by researchers to study user acceptance of IT theoretical models, also predict the user wishes to conduct an effective information system tools [Szajna 25, 1996], but such studies are mostly non-medical in the field of applied research.
TAM theory of the origin is for the use of IT userbehavior [Davis 15, 1989a];
model of streamlined, easy to use, and possessed a certain explanatory power [Hu et al. 17, 1999, Taylor & Todd 27,1995]; TAM questionnaire design on the reliability and validity is supported by many scholars explore and experiment with the
amendment, there is no need for different research topics of IT measurement tools for individual development [Adams et. al. 10,1994, Taylor & Todd 27 ,1995, Mathieson & Chin 21,2001]; 4), TAM organization in many studies, the overall explanatory power has a good evaluation of [Davis, 1989a 15, Davis et al. 16, 1989b, Mathieson 21, 1991, Szajna 25, 1996, Chau 14, 1996, Igbaria et al. 18, 1997, Huet al. 17, 1999]. TAM as the theoretical basis at home and abroad to study are very wide, which, Younghwaand others compiled from 1986 to 2003 6month of the world's leading information technology journals The use of TAM to the field of
information systems research papers, a total of 101. Younghwa and others in the study also for the impact of perceived ease of use, perceived usefulness, intention to use and actual use of external variables, to order a total of 21 variables
[Younghwa et.al 30, 2003]. The framework is based on this study and others have compiled Younghwaliterature-based, through expert advice, select the appropriate variables, actions that affect hospital nursing station received were discussed.
Nursing stations internal operations related to the research literature, such as the above only for institutions nursing station into the wireless LAN Factors influencing the development of care plans and the key factor system [Chen Yingling 5, 2003] [XiaoRuling 9, 2003]and with the new computer equipment and wireless communication technology and the development of prototype systems [Yan greatly 8, 2004], for the action side of nursing station is still a lack of user behavior. Also, at home and abroad to TAM as the theoretical basis of relevant research, but mostly non-medical fields of application. Therefore, the purpose of
this study to the theoretical basis of TAM under the user of the mobile nursing station acceptance.
Participation, materials and methods
Comprehensive literature review mentioned above and shown, and the experts on the characteristics of the proposed health care industry, proposed actions affecting the user acceptance factors Huli station for the "cognitive ease of use",
"perceived usefulness", "personal innovation", "support of executives ","
compatibility "and" security "6. Research framework shown in Figure 1.
As the current hospital nursing station into operation little research nurses on the acceptance of mobile nursing stations face behavior research topic is new, so this study uses case study method, choose a district teaching hospital inpatient care of all the use of action conducted a questionnaire survey of nurses station.
Select the target hospitals because the hospital is using a mobile nursing station south of the most popular of the hospital, the hospital started using the mobile nursing station time for the Republic of China on May 91, system development approach was independently developed, using input devices Secretary of personal action (PDA), system stability and the current continuous use.
Research tools, we use questionnaires to collect data of the work, as a basis for analysis. The questionnaire is divided into three parts, the first part of the basic data for the majority of the sample part, a total of 8issues. The second part is divided into factors affecting the mobile nursing station, a questionnaire
measuring scale
Table 1: variables in references
Variable name
Questionnair e
Question Number
References
Managers Support
3 Igbaria et al. [1997] 18 Liao and Landry [2000] 19
Personal
Innovativeness
4 Agarwal and Prasad [1999] 12 Agarwal and Karahanna [2000] 11
Phase Allow Sex
3 Chin and Gopal [1995] 14 Xia and Lee [2000] 29 Perceived usefulness 7 Hu et. Al., [1999] 17
Perceived ease of use
3 Hu et. Al., [1999] 17
Individual Difference 5 Lucas [1978] 20, Zmud [1979]
31
Safe All Sex 4 This Research
Study
Intention to use 3 Hu et. Al., [1999] 17
Likert-type scale questionnairecollected seven points, respectively, for 1to 7 indicating "strongly disagree" to "strongly agree" in order to understand the subjects for the understanding of the mobile nursing station, the title a total of 27 items. Asked the items within the scale shown in Table 1.
The third part is the implementation of mobile nursing station factors affecting the sequence, the higher the score the more important influence to a maximum of 6points, affecting 1of the lowest points, the number can not repeat the title a total of 6 items. Aspects of questionnaire reliability and validity, reliability measured by Cronbach α coefficients of scale internal consistency, α coefficient if higher than 0.7, the scale shall be high confidence [Wuming Long 2, 2003]. In this
study, samples were the object of research before the presentations, the target at the presence of 21 nursing staff to conduct pre-Shi, Jie Guo after pre-test show, the second part of the Zhi α scale value of 0.889, Gaoyulinjie Zhi 0.7, the letter
measurement results demonstrate that the study questionnaire, with acceptable reliability standards. The validity of some of validity by experts in law,
considered by experts, the expert group of the proposed amendments is limited to the wording of the amendment, therefore, this study only asked for the experts of the proposed changes to item wording, not removing any question items, to maintain the original 27 questions with the subject, Cronbach α of 0.88.
The statistical methods used in this study are summarized as follows: 1)
descriptive statistics or frequency percentage distribution (Descriptive Statistic): basic data method has been applied and the main variables describing the basic
features, such as title, highest degree, the distribution units to distribution of the data and its preliminary understanding of the basic characteristics. 2), Cronbach α
reliability analysis: scale test method has been applied to carry out reliability analysis, project analysis, to understand the differential level of scale items. 3),
factor analysis (Factor Analysis): 27 method has been applied to the questionnaire for data reduction work (Data Reduction) and benefit from the test work carried out follow-up. 4), single-factor analysis of variance (One-way ANOVA): test method has been applied to individual differences on the management of the support,
personal innovativeness, compatibility, perceived usefulness, perceived ease of use, security, and so each frame surface differences. 5), Pearson correlation coefficients (Pearson Product-moment Correlation): method has been applied for the manager's support, personal innovativeness, compatibility, perceived usefulness, perceived ease of use, safety and intended use, etc. For intention to use the relevant test. 6), multiple regression analysis (multiple step-wise regression): In this study, management support, personal innovativeness, compatibility, perceived usefulness, perceived ease and safety of other sixth variable to predict the variables used The method of the variance of "intention to use" predictive ability.
Wantonly, data analysis and results
The total of 185 questionnaires, 181 returned, recovery is 97.8%, of which 165 valid questionnaires, 16 valid questionnaires, the questionnaire explained 91.2%.
Basic data analysis and results, the staff
Factor
Name Variable content
1 Cognitive
Usefulness
14. Action after nursing station will help nurses more easily with the completion of work (.932)
16. I think that the care of patients using mobile nursing station is a good idea (.908)
15. Action after nursing station can use to enhance quality of care (.893)
17. To use the mobile nursing station on the benefit of my work (.873)
13. Action after nursing station used to improve my management and
professional skills (.852)
12. Action to reduce the nursing station, after I adopted nursing record time (.829)
11. Mobile nursing station immediately after use to understand disease progression in patients care will help to accelerate the completion of work (.663)
2 High
Charge
Support
7.Top management actively involved in development decision-making mobile nursing station (.886)
6.Top management to provide adequate resources into action care systems (.882)
5.Top managers is considerable support for the introduction of mobile nursing stations (.769)
3 Security 22. I worry that the system storing medical records may be altered by others (.914)
21. I worry that the system is not personal medical records will be authorized to take (.911)
4 Personal
Innovative
2.In my colleagues, I was among the first people to try out new information technology (-. 856)
4.I like to try new information technology (-. 781)
1.I have heard of a new information
technology I will try to test (-. 767)
5 Cognitive
Ease of use
9.I think the mobile nursing
information system is easy to learn (.768)
8.I think that the use of mobile nursing stations and lack of flexibility (.622)
10. I think the mobile nursing station's operation is easy (.581)
6
Compatibility
18. Mobile nursing station should be required to use the network
infrastructure and the
Compatible with the existing hospital network infrastructure (-. 875)
19. Action consistent with our hospital nursing station management beliefs and values (-. 861)
20. Operations and hospital nursing station hardware and software compatibility with existing systems (-.
822)
23. I am worried that the use of mobile devices prone to failure damage (-. 521)
That respect, N3 largest primary care, a total of 65.5%. Academic qualifications, the largest specialist qualifications, a total of 76.4%. Terms of total working years, 1-5 years (inclusive) of the largest, accounted for 53.3%. Action dimensions used in nursing stations, the largest number of the nursing assessment, a total of 39.7%, followed by care and the implementation of a total of 20.3%. The mobile nursing stations to provide the functions are divided into five dimensions, that is, record the care and information, master personal care, progress, performance evaluation heads of nuclear, Chaxun care 决策 or diagnosis the information or
recommendations and other features Deng Xiang Guan , entitled to check the subject, the results show that the care to record information of the largest,
accounted for 60.6%, followed by check or diagnostic care decision-making needed information, a total share of 16.8%. Nursing station to use in the operation time, from January to June (inclusive) of the largest, with a total of 39.7%. The mode of calculation by the use of mobile nursing station six factors influence, the order of
"usefulness of information systems", "information system easy to have sex",
"information system compatibility," "Information Technology maturity ","
Information systems security "and" top management's support. " Therefore can understand the mobile nursing station will not affect most users feel that the factors used to "top management's support."
To identify some of the potential and not easily observed structure factors, and try to use at least factor to explain the observed relationship between the phenomenon. Conducting factor analysis in this study before usingOne-Sample Kolmogorov-Smirnov Test for the second part of this scale, "Factors affecting the implementation of mobile nursing station" to test, to confirm the recovery of the questionnaire forms, whether the normal distribution, to facilitate follow-up case study conducted, this analysis revealed that the second part of "Factors affecting the implementation of mobile nursing stations," the 27 question items, and all appeared normal distribution. "Factors affecting the implementation of mobile nursing stations," the factor analysis extracted a total of six factors are the factors with the structure of this study fully agree, this may permit the literature, this research study are summarized variables, it is very suitable to analyze this study and discussed as shown in Table 2.
In the use of ANOVA analysis to test the basic variables and influence
respondents had action the relationship between factors of nursing station, title respect to the average of the highest nurse, education, working years, the name of no significant impact on nursing station. The current position of the working years and personal factors were significantly related to innovation, the analysis found that the current average working year terms of office of 2 to 5years (inclusive) of the highest average. The use of mobile nursing stations time and perceived usefulness, top management support, system security and
compatibility of the four factors were significantly related.
In this study, Pearsoncorrelation coefficients to test the independent variables and the "intended use" of the relationship, the results show that the use of intention and independent variables
Table 2, the content of the six factors with a list of variables
Variables were significant positive correlation exists (P <.01). A multiple
stepwise regression analysis (Stepwise Regression), based on all the variables and the relationship between intention to use each of the variables in regression of the formula, test the results of its intended use (see Table 3 shows the results please) ,Durbin-Watson value of 2.2, known from the literature when the value is about 2.0, indicating no residual autocorrelation; The VIF ranged from 1.244 ~ 1.755, and when the value is less than 10, said that each of the variables there was no collinearity exists (Wang Bao Jin, 1996). Based on the number of values of the regression analysis, the analysis shows that the regression equation to P <.05 significant level, their findings are as follows: "ease of use", "usefulness" and
"security of the system of" three variables, and the dependent variable "intention to use" was significantly related to the total explained variance (R2) was 0.349, using the above three variables to predict the "intended use", with 34.9% of the explained variability. Regression coefficient analysis can be found, "usefulness"
of the standardized coefficient (0.433) was the largest compared to other variables, namely variables "perceived usefulness" of the dependent variable "intention to use" have better explanatory power, users of mobile nursing stations for the
"usefulness" The higher the action on behalf of the nursing station's "intention to use" the higher. Similarly, other effects mobile nursing stations "intended use" of variables were "system security" and "perceived ease of use." The explanatory power of individual variables in order to "usefulness" of the best predictive power, which accounted for 25.3%, addition of "system security", which accounted for 8.7%, and finally as a "perceived ease of use nature ", which accounted for 2.7%.
5), reached a significant level above the three forecast variables, in accordance with its original score of the linear regression formula:
Intention to use perceived usefulness = 0.433× + 0.291× system security +0.153 × perceived ease of use
That is, for every 1degree of perceived usefulness, intention to use increased by an average of 0.433, the same token, security of the system increased by 1degree, the intent is to increase use of 0.391. Therefore, the higher scores of the three factors to show the motive and intention to use the more strongly.
Table 3: variables and intention to use multiple regression analysis table
Election
Variables
Order
Adjuste d R 2
F
valueSignificant F change
Standardize d regression coefficient
Collinearity Statistics
Toleranc e
VIF
Cognitive Useful
.253
51.495
.000 .433 .916
1.091
Safe All Sex .331
18.266
.000 .291 .986
1.014
Cognitive Use
.349 4.985 027 .153 .929
1.077 Durbin-Watson value: 2.222
Wu, conclusions and recommendations
The study by the literature, the establishment of research framework, the preparation of research tools and survey, data collection and analysis, the following conclusions:
1), affecting the usage of mobile nursing station intent: a multiple stepwise regression analysis found that affect the "intended use" of a total of three
variables, namely the "usefulness", "system security" and the "perceived ease of use sex. " As for the "individual initiative", "top management support" and
"compatibility" and the three variables for the "intended use" no significant difference. Among them, the "usefulness", the hospital medical staff hospital departments perceived usefulness of the information system degree of sexual identity strongly than other factors. Therefore, this research station in the mobile nursing empirical acceptance found quite consistent with the theory of TAM on behalf of TAM theory acceptance in the medical technology's effectiveness.
In general, the process of introduction of information system, with time to familiarize themselves with the degree of growth of IT users to IT's perceived usefulness, perceived ease of use will be increased, and further enhance the intended use. However, the use of mobile nursing stations time and factors affecting the mobile nursing station results have shown that using a mobile nursing station groups the longest (30 months or more) for the "usefulness" and
"system security" of the average minimum. And "ease of use" aspects, the
survey, to the mobile nursing station design, the input device is simple and easy to carry and operate, will affect the users to use mobile nursing station "intended use."
2) factors affecting the implementation of mobile nursing station order: impact of hospital inpatient nursing staff to accept the mobile nursing station factors, by order, the order of "usefulness of information systems", "ease of use of
information systems", "Information System Compatibility", "Information
technology maturity", "Information systems security" and the "top management's support." From this, the user is able to accept the mobile nursing station for the first factors considered, "the usefulness of the information system", once again confirm the results of regression analysis.
Based on the results of this paper is planning a hospital nursing station into operation the following recommendations:
Before the hospital build is required to understand the user of the actual mode of operation, demand and the difficulty encountered in the implementation of the work to design consistent with the work functions of different users of the right of the operating system, to enhance the efficiency of their work and study. And in
the system before importing, respectively after a regular basis with the
implementation of education and training, particularly in the specialized ability of the information, hospital information department staff capacity is usually low, it is proposed that hospitals need to understand the real users of information literacy and information technology for The extent of use, design a good friendly
operation interface to suit its needs. To enhance the user of the mobile nursing station acceptance.
And for "system security", since the user input data is worried about tampering or unauthorized use, but this study suggests that users of information security for the distrust with the organization of information security mechanism is not clear from in education and training is not implemented, and no express and publish information related to security regulations in two ways. Therefore, the proposed Medical Center needed to reinforce the content and implementation of education and training, and allow users to understand the importance of information
security and organization of information security. In those stipulated that organizations need to protect information security regulations, so that users understand the data is random tampering or unauthorized use of data penalties,
so that users of mobile nursing stations to protect information security for organizations with confidence, which finally led to the positive intended use, to build the effectiveness of mobile nursing stations.
Follow-up research also presents five suggestions:
1), expand the object of study: Introduction of the current mobile nursing stations and related research is still in hospital in China started from the beginning, but wireless technology is in the blooming stage, together with the government in health care policy on the promotion and support, follow-up to build the mobile nursing station hospital is bound to sprout up in the surface, and hospital nursing station for action into the acceptance should be a worthwhile subject for study.
Follow-up study is to extend the study to the entire country has to import the mobile nursing station hospital nursing staff to fully and effectively enhance the acceptance of mobile nursing station.
2) increase the research variables: According to the results of this study,
"usefulness," "system security" and "perceived ease of use" of the three factors affecting the mobile nursing station "intended use" important factor. Therefore, the follow-up researchers to further explore the impact of the three variables of the external variables, such as information literacy, in order to get more of the research results.
3) improve research tools: The research on the various variables of the research questionnaire mainly refer to a number of scholars doing research forTAM compiled, was going through the pre-test reliability and validity of the test, whether the contents of the questionnaire including all of the mobile nursing stations should include the important content, the researchers still need to explore the follow-up. Moreover, research cited in the literature scale basis, are from foreign literature, although the questionnaire has a high degree of reliability and validity. However, apart from cultural differences, the questionnaire does not necessarily apply subject to their own country and are not the same for the systems, therefore, issues related to domestic researchers in the study, the research system can be for domestic properties and the status to be amendment further explore and develop an appropriate measure.
4), both qualitative and quantitative research Xing methods of research: the study to literature, surveys, and case-study for the The main Fangfa, Therefore, its reasoning on the study findings, still not enough in-depth information on Yin Liang
Hua and Wan Zhenger limiting. Therefore, the proposed follow-up of the researchers may try the "quality and quantity" of research methods, from
"quality" aspect of intercept and understand the use of mobile nursing station user attitude, factors, application status, and encountered difficulties, etc, so can nursing station on the action the user have a better understanding and to develop a research topic, with the way quantitative research supporting each other, reflecting the current situation.
5), longitudinal analysis: In this study, nursing station for mobile users not to observe the use of mobile nursing station as a whole process, conduct
longitudinal research methods to master the mobile nursing station of the user acceptance process of change. "Time" factor for the "usefulness", "ease of use"
and "willingness to use" the relationships between them change. Follow-up study could refer Szajna research model to study the system in actual operation before and after differences between the [Szajna 25, 1996], to enhance user acceptance of mobile nursing station of the vertical depth of change.
This paper presents two studies limits, a), this study only for a case of a regional hospital in southern census, it is pushed beyond a relatively low validity, although the subjects of research hospitals into action for the better the effectiveness of hospital nursing stations, but research whether the inference to a hospital or other medical center in northern, conservative opinions in this study. 2), this study tool for the self-report rating scale, participants in Respondents, the measurements for the main variables are the cognitive response by subjects to complete; However, inter-personal awareness and the actual situation may have some differences, therefore, the response scale results are not entirely realistic. In addition, subjects in the Respondents may be social desirability or situational, emotional and uncontrollable factors, so the situation on the questionnaire and explain the cognitive subject, it might vary, but there is error of measurement.
In addition to using the mobile nursing station can reduce the artificial errors, the through electronic medical assistance to improve the care beds each, and then to expand the hospital size and the purpose of streamlining. In person, because wireless communication has at any time, anywhere communication performance, increasing the times of emergency information to obtain the correct efficiency of health care workers, it is likely that the key to life and death. The results of this study by the TAM model in addition to verifiable, and expand the research used in the medical field, will also help us to understand user acceptance of information
technology factors affecting operations and provide those planning a hospital nursing station reference, can decrease the risk of import failure.
Lu, references(upon request)
