Digital health as an embedded part of nursing homes : an in-depth examination of the impact of the electronic health record

Efficient management of patient data and medication safety are crucial in nursing homes where nursing staff perform complex and often time-sensitive tasks at the same time as there is a shortage of personnel. This thesis explores the implementation and impact of Iðunn, a registration application for care tasks, and Lyfjavaki, a medication registration application, two electronic health record systems designed to streamline the nursing staff workflow and improve patient care. The purpose of this thesis is to examine (i) how these digital applications influence nurses' workflows and (ii) to evaluate the implementation processes. The research focuses on understanding the solution's impact on daily tasks and identifying potential improvements in the implementation process. Using action research, including 20 interviews with key stakeholders (developers, nursing department heads, and nursing staff) and a time-in-motion study that included 58 hours of observation, the widest range of data was obtained. The findings reveal that Lyfjavaki significantly improved medication safety and ensured legal compliance for medication registration without significantly increasing the registration time. Iðunn enhanced the quality of clinical registration and showed significant time savings, with an average of 26.13 minutes less spent on registration tasks (p=0.039) where it had been implemented. Additional efficiency was observed, including a 54-minute reduction (p=0.020) in report time and an increase in time spent with residents by an average of 108.57 minutes (p=0.039) in facilities where Iðunn was implemented. This study concludes that integrating applications like Iðunn and Lyfjavaki in nursing homes can improve both patient safety and nursing staff workflow efficiency. However, this study showed the implementation process to be challenging, with the main obstacles being the department heads' limited time and resistance from other staff members. The main contribution of this thesis is the development of guidelines to support further implementations of digital solutions, aiming for smoother adoption and maximizing the benefits of application implementation. These guidelines emphasize thorough preparation, tailored training, and ongoing support to address key challenges in the implementation process.

Author dc:creator

• Henný Björk Birgisdóttir 1993-

Contributors dc:contributor

• Háskólinn í Reykjavík

• Tölvunarfræði
• Meistaraprófsritgerðir
• Heilsufarsupplýsingar
• Rafræn gögn
• Hjúkrunarheimili
• Computer science
• Medical records--Data processing
• Nursing homes

Language dc:language.iso

en

Handle dc:identifier.uri

https://hdl.handle.net/1946/49069

OAI identifier oai:identifier

oai:skemman.is:1946/49069