Dietary behavior and its influencing factors among experienced shiftwork nurses: a secondary analysis.

PURPOSE: This study investigated the dietary behavior of experienced shiftwork nurses and aimed to identify factors related to dietary behavior. METHODS: This study was a secondary analysis based on the Shift Work Nurses' Health and Turnover study (2018-2021) among Korean nurses. In total, 247 experienced (>12 months) shiftwork nurses were included in this study. The participants' dietary behavior, depression, level of occupational stress, fatigue, physical activity, and general characteristics were measured. Descriptive statistics, Pearson correlation coefficients, independent t-test, one-way analysis of variance, the Kruskal-Wallis test, and multiple regression analysis were conducted. RESULTS: The dietary behavior score of the participants using the Mini-Dietary Assessment Index was 29.35±5.67. Thirty percent of the participants were depressed, the participants experienced moderate occupational stress, and 74.1% of the participants engaged in an inadequate amount of physical activity. The factors influencing shiftwork nurses' dietary behavior were having child(ren) (ß=.16, p=.027), depression (ß=-.13, p=.032), level of occupational stress related to occupational climate (ß=-.13, p=.035), and an inadequate amount of physical activity (ß=-.17, p=.006). These factors explained 10.4% of the variance in experienced shiftwork nurses' dietary behavior scores. CONCLUSION: Experienced nurses with child(ren) tended to have healthier diets. However, a higher level of occupational stress related to occupational climate, depression, and engaging in an inadequate amount of physical activity were associated with a higher risk of having an unhealthy diet. Therefore, strategies are needed to encourage physical activity and alleviate adverse occupational climate and depression among experienced nurses.

Comparing usability testing outcomes and functions of six electronic nursing record systems.

OBJECTIVES: This study examined the usability of six differing electronic nursing record (ENR) systems on the efficiency, proficiency and available functions for documenting nursing care and subsequently compared the results to nurses' perceived satisfaction from a previous study. METHODS: The six hospitals had different ENR systems, all with narrative nursing notes in use for more than three years. Stratified by type of nursing unit, 54 staff nurses were digitally recorded during on-site usability testing by employing validated patient care scenarios and think-aloud protocols. The time to complete specific tasks was also measured. Qualitative performance data were converted into scores on efficiency (relevancy), proficiency (accuracy), and a competency index using scoring schemes described by McGuire and Babbott. Six nurse managers and the researchers completed assessments of available ENR functions and examined computerized nursing process components including the linkages among them. RESULTS: For the usability test, participants' mean efficiency score was 94.2% (95% CI, 91.4-96.9%). The mean proficiency was 60.6% (95% CI, 54.3-66.8%), and the mean competency index was 59.5% (95% CI, 52.9-66.0). Efficiency scores were significantly different across ENRs as was the time to complete tasks, ranging from 226.3 to 457.2s (χ(2)=12.3, P=0.031; χ(2)=11.2, P=0.048). No significant differences were seen for proficiency scores. The coverage of the various ENRs' nursing process ranged from 67% to 100%, but only two systems had complete integration of nursing components. Two systems with high efficiency and proficiency scores had much lower usability test scores and perceived user satisfaction along with more complex navigation patterns. CONCLUSIONS: In terms of system usability and functions, different levels of sophistication of and interaction performance with ENR systems exist in practice. This suggests that ENRs may have variable impacts on clinical outcomes and care quality. Future studies are needed to explore ENR impact on nursing care quality, efficiency, and safety.

Evaluation of the completeness of the nursing process for patients having gastrectomy using electronic nursing records.

The purpose of this study was to evaluate recording completeness of the nursing process. We compared nursing statements documented at the time when the Electronic Nursing Record (ENR) system, based on the ICNP, was implemented in 2004 with those documented in 2007. The ENRs for 35 gastrectomy patients in each year were selected for evaluation. The selected data were 11,822 nursing statements in 2004 and 27,870 in 2007. The results indicated a significant increase in the completeness of the nursing process in 2007. In addition, the number of nursing diagnosis increased by 5.1 times. The most contributing factor for this increase is assumed to be nurse education.

A content analysis of the nursing records pre- and post-implementation of an electronic nursing record system.

After the application of an EMR system in 2004, we could find the meaningful differences in the content of nursing records in a tertiary teaching hospital, Seoul, Korea.

Comparison of direct and indirect nursing-care times between physician order entry system and electronic medical records.

This study compared the amount of time spent by nursing personnel on direct and indirect nursing care between a physician order entry (POE) system and an electronic medical record (EMR) system. Nursing-care time was measured by direct observation or a self-reporting method, both using a stopwatch. Nursing activities were categorized according to modified versions of the tools reported by Park. The implementation of an EMR system increased the direct nursing-care times for all nursing positions. However, the indirect nursing-care times of head nurses and nurse aids was lower, whereas that of registered nurses was higher, and the direct and indirect nursing-care times of RNs varied with the nursing unit and shift. The increases in direct nursing times, especially that spent by nurses providing descriptions and education to patients at their bedside, led to a global improvement in the nursing quality, and the indirect nursing times varied with the nursing position.