What challenges and enabling factors influence the effective use of digital systems among staff working in an acute paediatric setting?

Introduction: The NHS Wales Paediatric Welsh Nursing Care Record (Paeds WNCR) project aims to standardise and digitalise paediatric inpatient and risk assessment documents across Wales. This research, conducted in a rural Health Board (HB) in West and Mid Wales, examines the sociotechnical environment and how the multidisciplinary team (MDT) interact with the current digital systems. Methods: A pre-implementation study assessed the usability of the Welsh Clinical Portal (WCP) and WelshPas (WPas) using the industry-standard System Usability Scale (SUS) along with open-ended surveys. The study also explored the digital confidence and attitudes of the staff. Results: The SUS scores indicated that both WCP (mean and median = 61.25) and WPas (mean=62.27, median = 62.50) fall below the industry standard for acceptable usability (n=68), suggesting an urgent need for improvement. Qualitative feedback revealed diverse staff experiences and an ethnographic-narrative approach was used to describe their lived experiences. Discussion: Four themes emerged: user experience and confidence, benefits, challenges, and change. The complexity of factors affecting digital system use was categorized into three themes: Health Information Technology, Clinical Standards, and Change Management. These factors can be plotted along a continuum that ranges from challenging to beneficial. The exact impact of each factor is very individual to that person. Conclusion: Despite the limited generalisability due to small sample sizes, this research provides insights into the current use of digital record-keeping systems and HIT in clinical practice by paediatric staff. It highlights the scarcity of prior research focused on paediatric staff’s experiences with HIT implementation and the sheer frustration, anger and irritation expressed by the majority of the HCPs, which mirrors the negative influences caused by poorly performing digital devices, slow Wi-Fi networks, system interfaces that do not support clinical workflows. This research on the perspectives and practices of this group of paediatric staff has the potential to contribute new insights to the field, specifically within the hospital-based paediatric areas in Wales.

Name dc:type.qualificationname

msc

Level dc:type.qualificationlevel

masters

Grantor dc:publisher.institution

University of Wales Trinity Saint David

Year dc:date.issued

2024

Author dc:creator

• Perry, Sian

• RT Nyrsio

Dc Identifier Grantnumber

UWTSD

OAI identifier oai:identifier

oai:repository.uwtsd.ac.uk:3058