Proposing Electronic Health Record Usability Requirements Based on Enriched ISO 9241 Metric Usability Model.

INTRODUCTION: System usability assessment is among the important aspects in assessing the quality of clinical information technology, especially when the end users of the system are concerned. This study aims at providing a comprehensive list of system usability. METHODS: This research is a descriptive cross-sectional one conducted using Delphi technique in three phases in 2013. After experts' ideas were concluded, the final version of the questionnaire including 163 items in three phases was presented to 40 users of information systems in hospitals. The grading ranged from 0-4. Data analysis was conducted using SPSS software. Those requirements with a mean point of three or higher were finally confirmed. RESULTS: The list of system usability requirements for electronic health record was designed and confirmed in nine areas including suitability for the task (24 items), self-descriptiveness (22 items), controllability (19 questions), conformity with user expectations (25 items), error tolerance (21 items), suitability for individualization (7 items), suitability for learning (19 items), visual clarity (18 items) and auditory presentation (8 items). CONCLUSION: A relatively comprehensive model including useful requirements for using EHR was presented which can increase functionality, effectiveness and users' satisfaction. Thus, it is suggested that the present model be adopted by system designers and healthcare system institutions to assess those systems.

Nurses' knowledge and performance of the patients' bill of rights.

BACKGROUND: Observance of the patients' bill of rights is one of the main features of moral codes in hospitals. In this regard, nurses bear great responsibility because they spend a long time with patients. Therefore, the continuous evaluation of the nurses' performance and assessing their knowledge about the patients' bill of rights are a need. OBJECTIVES: We aimed to determine the nurses' awareness of the patients' rights and measure their performance in this regard. Research design and participants: This cross-sectional study was carried out in 2013. To measure the nurses' knowledge and performance, 250 nurses and 300 patients were surveyed. The participants were selected randomly from five teaching hospitals in Tehran, Iran. Two questionnaires, one for nurses (17 questions) and the other for patients (11 questions), were applied. The data were analyzed in SPSS software using descriptive and inferential statistics. Ethical consideration: The research protocol was submitted and approved by the research and ethics committees of the participating hospitals. Additionally, the consent of all of the participants was obtained before the study. FINDINGS: The mean score of the nurses' knowledge regarding the patients' rights was acceptable (69.85 ± 11.7 of 85). Furthermore, the mean score of nurses' performance in observing the patients' rights was relatively acceptable (11.2 ± 4.6 of 22). More experienced and educated nurses had higher knowledge regarding the patients' rights, and patients with higher education level or experience of being hospitalized were less satisfied with the nurses' performance. CONCLUSION: Nurses' knowledge of the patients' bill of rights was acceptable; however, observance of the patients' rights was not. It seems that notification of the patients' bill of rights has increased the nurses' awareness of the patients' rights, although improvement of the nurses' performance needs more extensive measures.