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Golay, D., Cajander, Å. & Salminen-Karlsson, M. (2023). Information Technology Use and Tasks Left Undone by Nursing Staff: A Qualitative Analysis. Health Informatics Journal, 29(4), 1-10
Open this publication in new window or tab >>Information Technology Use and Tasks Left Undone by Nursing Staff: A Qualitative Analysis
2023 (English)In: Health Informatics Journal, ISSN 1460-4582, E-ISSN 1741-2811, Vol. 29, no 4, p. 1-10Article in journal (Refereed) Published
Abstract [en]

Nursing staff perceive information technology (IT) as time-consuming and impinging on direct patient care time. Despite this, researchers have directed little attention toward the interplay between IT use and tasks left undone by nursing staff. In this paper, we analyze interview and focus group data on hospital nursing staff’s experience working with IT to identify ways IT use interacts with tasks left undone. We found that tasks left undone by nursing staff can have IT-related antecedents and that IT-related tasks are also sometimes left undone. This analysis adds to the body of knowledge by showing that tasks related to the work environment and IT can be left undone and that nursing staff avoid certain IT-supported tasks because they do not know how to do them or why they ought to be done. These findings form the basis for our call for further research on the topic.

Place, publisher, year, edition, pages
Sage Publications, 2023
Keywords
health information technology, hospitals, nursing assistants, nurses, care left undone, tasks left undone
National Category
Computer Systems
Research subject
Computer Science with specialization in Human-Computer Interaction
Identifiers
urn:nbn:se:uu:diva-485497 (URN)10.1177/14604582231207743 (DOI)001088158600001 ()37882139 (PubMedID)
Available from: 2022-09-23 Created: 2022-09-23 Last updated: 2023-11-13Bibliographically approved
Golay, D., Sving, C. & Cajander, Å. (2022). An Emotion-driven Approach to Hospital Physicians' Work-Related User Experience. In: Proceedings 10th Nordic Conference on Human-Computer Interaction - NordiCHI '22: . Paper presented at NordiCHI'22. Association for Computing Machinery (ACM) Association for Computing Machinery (ACM)
Open this publication in new window or tab >>An Emotion-driven Approach to Hospital Physicians' Work-Related User Experience
2022 (English)In: Proceedings 10th Nordic Conference on Human-Computer Interaction - NordiCHI '22, Association for Computing Machinery (ACM) Association for Computing Machinery (ACM), 2022Conference paper, Published paper (Refereed)
Abstract [en]

Recent studies have found a correlation between information technologyuse and physician burnout, though little is known aboutphysicians’ workplace user experience. Thus, this paper examinesphysicians’ work with electronic medication orders through a userexperience and well-being lens. We interviewed ten physiciansworking clinically at a large Swedish hospital and analyzed theirexperiences qualitatively from an emotion-driven perspective. Participants’stories were associated with joy, relaxation, confusion,anxiety, and frustration. On this basis, we formulated four UX goals:I feel joy as I complete my IT-supported tasks quickly and effortlessly,the steps I carry out feel meaningful as I understand their purpose,I feel confident on how to proceed to produce the outcome I want,and I experience relaxation as I feel supported in minimizing risk ofpatient harm. By (re)designing health IT systems and practices tofoster these positive experiences, health IT designers may improvephysician work well-being.

Place, publisher, year, edition, pages
Association for Computing Machinery (ACM)Association for Computing Machinery (ACM), 2022
National Category
Computer Systems
Research subject
Computer Science with specialization in Human-Computer Interaction
Identifiers
urn:nbn:se:uu:diva-485496 (URN)10.1145/3546155.3546684 (DOI)9781450396998 (ISBN)
Conference
NordiCHI'22
Available from: 2022-09-23 Created: 2022-09-23 Last updated: 2024-01-15Bibliographically approved
Golay, D. (2022). An Emotion-Focused Approach Towards Improving Clinicians' Work-Related User Experience. (Doctoral dissertation). Uppsala: Acta Universitatis Upsaliensis
Open this publication in new window or tab >>An Emotion-Focused Approach Towards Improving Clinicians' Work-Related User Experience
2022 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Recent studies have associated clinician burnout with health information technology use. Researchers have attributed this negative impact of health information technology use on clinician well-being to poor system usability and insufficient clinician involvement in system design and implementation.

Against this backdrop, this thesis first examined the discrete negative and positive emotions that clinicians experience at work in connection with health information technology use, and defined desirable user experience goals for health information technology design and implementation. Second, it identified different breakdowns in the communication between hospital nursing staff and information technology staff members.

Data were collected through focus groups and interviews with registered nurses, nursing assistants, physicians, and information technology staff members working at or affiliated with a large Swedish hospital. The data were analyzed qualitatively through thematic analysis.

Hospital nursing staff and physicians were found to experience frustration, perplexity, anxiety, alienation, psychological and moral distress, joy, relief, relaxation, and confidence in connection with their work-related use of health information technology. On this basis, joy, relaxation, confidence, gratitude and pride were identified as desirable user experience goals for clinicians' work-related information technology use. Finally, breakdowns in the communication between hospital nursing staff and information technology staff members were found to include lack of user studies, low-level filtering of nursing staff's electronic error reports, unintelligible electronic error reports, and nursing staff not attending in-person training sessions and not checking information technology-related communications on the intranet.

These findings contribute to the field of human─computer interaction by shedding light on information technology staff members' work and on clinicians' work-related user experience, and by defining user experience goals for clinicians' work-related information technology use. Health information technology designers and implementers can draw from these findings to foster clinician well-being through the design of health information technology systems and routines.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2022. p. 94
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Science and Technology, ISSN 1651-6214 ; 2196
National Category
Computer Systems
Identifiers
urn:nbn:se:uu:diva-485498 (URN)978-91-513-1609-3 (ISBN)
Public defence
2022-11-25, Heinz-Otto Kreiss-salen (101195), Ångströmlaboratoriet, Lägerhyddsvägen 1, Uppsala, 13:00 (English)
Opponent
Supervisors
Available from: 2022-11-03 Created: 2022-09-23 Last updated: 2022-11-03
Golay, D., Salminen-Karlsson, M. & Cajander, Å. (2022). Effortlessness and Security: Nurses' Positive Experiences With Work-Related Information Technology Use. Computers, Informatics, Nursing, 40(9), 589-597
Open this publication in new window or tab >>Effortlessness and Security: Nurses' Positive Experiences With Work-Related Information Technology Use
2022 (English)In: Computers, Informatics, Nursing, ISSN 1538-2931, E-ISSN 1538-9774, Vol. 40, no 9, p. 589-597Article in journal (Refereed) Published
Abstract [en]

Nurses' well-being at work has been an increasing concern the past few years, in particular in connection with work-related information technology use. Researchers have thus been called to explore ways of fostering nurses' well-being at work. However, little is known about the factors related to information technology that contribute to nurses' positive experience of and well-being at work. In this study, we sought to understand the appraisals and emotions at the core of nurses' positive experiences with information technology use at work. We conducted focus groups and semistructured interviews with 15 ward nurses working at a large Swedish hospital. The data were analyzed qualitatively using process and causation coding. We found appraisals of easy goal accomplishment, doing less of a particular task, knowing what the situation is and what has to be done, mastering the system, reduced risk of mistakes and omissions, and assured access to patient information. Using design theory, we connected these appraisals with four positive emotions: joy, relief, confidence, and relaxation. These findings suggest that effortlessness and security are central to nurses' positive experience of information technology. Implementing information technology–related features and practices associated with them in healthcare organizations may foster nurses' well-being at work.

Place, publisher, year, edition, pages
Wolters Kluwer, 2022
National Category
Human Computer Interaction
Research subject
Computer Science with specialization in Human-Computer Interaction
Identifiers
urn:nbn:se:uu:diva-475006 (URN)10.1097/cin.0000000000000917 (DOI)000852246400003 ()35475766 (PubMedID)
Available from: 2022-05-27 Created: 2022-05-27 Last updated: 2023-08-30Bibliographically approved
Salminen-Karlsson, M. & Golay, D. (2022). Information systems in nurses' work: Technical rationality versus an ethic of care. New technology, work and employment, 37(2), 270-287
Open this publication in new window or tab >>Information systems in nurses' work: Technical rationality versus an ethic of care
2022 (English)In: New technology, work and employment, ISSN 0268-1072, E-ISSN 1468-005X, Vol. 37, no 2, p. 270-287Article in journal (Refereed) Published
Abstract [en]

Nurses increasingly interact with health information systems (HIS) in their daily work. This article examines how the problems that they confront in that interaction can be understood through the theoretical concepts of technical rationality and an ethic of care. The findings are based on a qualitative study of nurses in one Swedish hospital. They suggest that HIS did not support the holistic care of patients, and were not adapted to the varied and often urgent situations that nurses faced in their daily work, leaving them feeling isolated with their problems. In summary, HIS were found to serve the administrative aims of a hospital organisation, based on technical rationality, rather than supporting patients' needs as seen from an ethics of care perspective. The contribution of the study is to show how the use of these two conceptual tools connects nurses' daily problems with HIS to more fundamental issues about the values upon which healthcare is grounded.

Place, publisher, year, edition, pages
John Wiley & SonsWiley, 2022
National Category
Work Sciences
Research subject
Sociology
Identifiers
urn:nbn:se:uu:diva-480787 (URN)10.1111/ntwe.12231 (DOI)000752130500001 ()
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare
Available from: 2022-07-19 Created: 2022-07-19 Last updated: 2024-01-15Bibliographically approved
Golay, D., Salminen-Karlsson, M. & Cajander, Å. (2022). Negative emotions induced by work-related information technology use in hospital nursing. Computers, Informatics, Nursing, 40(2), 113-120
Open this publication in new window or tab >>Negative emotions induced by work-related information technology use in hospital nursing
2022 (English)In: Computers, Informatics, Nursing, ISSN 1538-2931, E-ISSN 1538-9774, Vol. 40, no 2, p. 113-120Article in journal (Refereed) Published
Abstract [en]

There is a lack of research into the implications of information technology-related issues for nurses' experiences and well-being at work. However, negative work experiences can generate negative emotions, which, in turn, can negatively affect well-being. Despite this, research has not systematically addressed negative emotions generated by work-related information technology use in hospital nursing. Drawing on data collected through focus groups and interviews with a total of 15 ward nurses, this paper identifies the discrete negative emotions that emerge from work-related information technology use in hospital nursing and maps the identified emotions onto the perceptions associated with and triggering them. The analysis was qualitative and included process, emotion, and causation coding alongside extensive memo writing. We identified six primary negative emotions: frustration, moral distress, alienation, psychological distress, anxiety, and perplexity. All of the identified emotions can be associated with four types of experiences of feeling hindered: mental effort, inability to carry out a task, doing extra or unnecessary work, and failing to complete a task successfully. The framework we present may support healthcare organizations in identifying potentially harmful information technology-related configurations in their infrastructure and implementing appropriate measures to foster nurses' well-being at work.

Place, publisher, year, edition, pages
Ovid Technologies (Wolters Kluwer Health), 2022
Keywords
Emotions, Hospital nursing staff, Information communication technology, Nursing informatics, Occupational health o
National Category
Interaction Technologies Nursing
Research subject
Computer Science with specialization in Human-Computer Interaction
Identifiers
urn:nbn:se:uu:diva-450836 (URN)10.1097/CIN.0000000000000800 (DOI)000750741800007 ()34347645 (PubMedID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2016-07153
Available from: 2021-08-19 Created: 2021-08-19 Last updated: 2023-01-09Bibliographically approved
Daniels, M., Cajander, Å., McDermott, R., Vasilcheko, A. & Golay, D. (2021). Why Don't You Tell Me What I Need to Know?: Self-Flipped Classroom and Students' Personal Epistemology. In: 2021 IEEE Frontiers in Education Conference (FIE): . Paper presented at 2021 IEEE Frontiers in Education Conference (FIE), Lincoln, NE, USA, 13-16 October, 2021. Institute of Electrical and Electronics Engineers (IEEE)
Open this publication in new window or tab >>Why Don't You Tell Me What I Need to Know?: Self-Flipped Classroom and Students' Personal Epistemology
Show others...
2021 (English)In: 2021 IEEE Frontiers in Education Conference (FIE), Institute of Electrical and Electronics Engineers (IEEE), 2021Conference paper, Published paper (Refereed)
Abstract [en]

This is a full research paper addressing the crucial element of understanding students when creating learning environments. It is for instance important to be aware of how students appreciate our way of teaching and to consider consequences of students not understanding or plainly disliking a setup. This paper addresses the negative experiences of students in a peer-learning environment named the self-flipped classroom. Through the lens of a theory of personal epistemology we investigate course evaluation reports and observations from anonymous students. Results indicate that the personal epistemology framework indeed gives some answers to students disliking the self-flipped aspect of the course, and that some students would rather be told what to learn in detail as in the quote: “why don't you tell me what I need to know?”. Finally the paper presents some ideas on ways forward.

Place, publisher, year, edition, pages
Institute of Electrical and Electronics Engineers (IEEE), 2021
National Category
Other Computer and Information Science Didactics
Research subject
Computer Science with specialization in Computer Science Education Research; Computing Education Research
Identifiers
urn:nbn:se:uu:diva-463712 (URN)10.1109/fie49875.2021.9637355 (DOI)000821947700244 ()978-1-6654-3851-3 (ISBN)
Conference
2021 IEEE Frontiers in Education Conference (FIE), Lincoln, NE, USA, 13-16 October, 2021
Available from: 2022-01-11 Created: 2022-01-11 Last updated: 2023-01-09Bibliographically approved
Golay, D., Cajander, Å., Hussein, D., Azeez, A. & Bonacina, S. (2020). Communication Breakdowns between Nurses and IT Department: Why Hospitals Fail at Improving the Usability of Health Information Technology. In: Proceedings of the 18th International Symposium on Health Information Management Research: . Paper presented at International Symposium on Health Information Management Research.
Open this publication in new window or tab >>Communication Breakdowns between Nurses and IT Department: Why Hospitals Fail at Improving the Usability of Health Information Technology
Show others...
2020 (English)In: Proceedings of the 18th International Symposium on Health Information Management Research, 2020Conference paper, Published paper (Refereed)
Abstract [en]

Often, Health Information Technology (HIT) in hospitals consists of off the shelf systems that are configured and implemented by IT department workers. This means that these employees have a significant impact of the usability of HIT systems. Nonetheless, we currently do not know how IT department workers work. This prevents us from formulating educated recommendations aimed at improving HIT usability, known to be poor, especially from nurses’ perspective. In this paper, we hence present the results from an interview study, shedding light on 1) the communication channels that exist between nurses and IT department at a large public hospital in Sweden, and 2) the problems that undermine system-related communication between these two groups. Our findings stress the need for successful two-way communication between nurses and IT department in order to improve the usability of HIT in use.

Keywords
End User Involvement, Health Information Technology, IT Department, Nurses, User-Centred Design
National Category
Interaction Technologies
Research subject
Computer Science with specialization in Human-Computer Interaction
Identifiers
urn:nbn:se:uu:diva-419871 (URN)978-91-89081-09-3 (ISBN)
Conference
International Symposium on Health Information Management Research
Projects
DISA
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2016-07153
Available from: 2020-09-17 Created: 2020-09-17 Last updated: 2023-01-09Bibliographically approved
Salminen-Karlsson, M., Golay, D. & Cajander, Å. (2020). Den digitala arbetsmiljön inomhälso- och sjukvården. In: Göran Petersson, Martin Rydmark och Anders Thurin , (Ed.), Medicinsk informatik: . Liber
Open this publication in new window or tab >>Den digitala arbetsmiljön inomhälso- och sjukvården
2020 (Swedish)In: Medicinsk informatik / [ed] Göran Petersson, Martin Rydmark och Anders Thurin ,, Liber, 2020Chapter in book (Other (popular science, discussion, etc.))
Place, publisher, year, edition, pages
Liber, 2020
National Category
Human Computer Interaction
Research subject
Human-Computer Interaction
Identifiers
urn:nbn:se:uu:diva-425235 (URN)978-91-47-13408-3 (ISBN)
Available from: 2020-11-13 Created: 2020-11-13 Last updated: 2021-01-14Bibliographically approved
Golay, D. (2019). An invisible burden: An experience-based approach to nurses' daily work life with healthcare information technology. (Licentiate dissertation). Uppsala University
Open this publication in new window or tab >>An invisible burden: An experience-based approach to nurses' daily work life with healthcare information technology
2019 (English)Licentiate thesis, comprehensive summary (Other academic)
Abstract [en]

Information and Communication Technology (ICT) has been an increasingly pervasive component of most workplaces throughout the past half century. In healthcare, the turn to the digital has resulted into the broad implementation of Healthcare Information Technology (HIT). The impacts of ICT on work life have been investigated predominantly through surveys, although some researchers have advocated for the use of a qualitative, experience-based approach. Meanwhile, the existing body of research on the impacts of HIT on clinicians has painted a mixed picture of digitalization. Despite some clear benefits, HIT has indeed been found to have unexpected, unintended adverse consequences for hospital staff. Typical issues include loss in efficiency, extra effort to carry out routine tasks, and the creation of new, HIT-induced work activities. Simultaneously, research outside of the healthcare domain has shown that ICT could require extra effort from some users in order for the sociotechnical system to function properly – extra work often invisible to developers.

Based on observation, interview and focus group data collected at a large Swedish hospital, this thesis set out to investigate the impact of HIT on hospital nurses from an experience-based perspective, resulting in four main contributions. First, a method supporting experience-based data analysis, the HolisticUX method, is introduced. Second, 13 forms of HIT-induced additional tasks in nurses' workload are identified, five of which are not acknowledged in previous research. Third, task avoidance is identified as a consequence of nurses' increased workload, negatively affecting patient safety, care quality and nurses' professional satisfaction. Finally, four factors are argued to contribute to a suggested invisibility of the HIT-induced time burden in nurses' work life to management and developers: 1) lack of a holistic perspective, 2) the hidden cost of a single click, 3) the invisibility of nursing work, and 4) visible data, invisible work.

Place, publisher, year, edition, pages
Uppsala University, 2019
Series
Information technology licentiate theses: Licentiate theses from the Department of Information Technology, ISSN 1404-5117 ; 2019-001
National Category
Human Computer Interaction
Research subject
Computer Science with specialization in Human-Computer Interaction
Identifiers
urn:nbn:se:uu:diva-381433 (URN)
Supervisors
Available from: 2019-02-22 Created: 2019-04-09 Last updated: 2019-04-09Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-8240-0942

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