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MODEL SUMMARY PRESENTATION

RESEARCH AREA: NURSING RESEARCH

PROPOSED RESEARCH TOPIC: IMPACT OF TECNOLOGY ON NURSING
DOCUMENTATION; A STUDY AT 37 MILITARY HOSPITAL, GREATER
ACCRA REGION.

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THEORITICAL UNDERPINNING

 In developing the model, it identified elements of healthcare structure and

processes that should be assessed concurrently with the outcome variables
of quality and safety.

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MODEL DESCRIPTION

 In addition, it incorporated the socio-technical perspective that the

organization, technology, and users would influence and change each other,
especially through the processes.
 It describes the constructs that constitute the model, without specifying how
they should be assessed.
 Assessment methods can be selected according to the resources of the
researcher and to the research question at hand.

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STRUCTURE OF MODEL

 In the Triangle Model, the relevant elements of structure are:

 The technology
 The healthcare organization
 The healthcare provider (user) and
 The patients receiving care

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PICTORIAL PRESENTATION

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THE TECHNOLOGY

 In order to assess impact, it is first necessary to inventory the functional

capabilities that could affect quality or safety.
 These would include issues such as the usability of the user interface and
the availability of clinical decision support or interfaces with other
systems.
 Hardware issues and system reliability are also relevant to technology
performance.
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THE PROVIDER

 The healthcare provider who uses the system has attributes that may affect
quality and safety outcomes, such as years in practice, training, and attitude
toward quality improvement.

 In addition, some provider attributes such as specialty, typing skills, EHR

training and experience, and age may influence how much they use the
technology.
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THE ORGANIZATION

 Organizational mission, resources, and policies affect quality outcomes

directly and also influence how well a technology is used to pursue these
outcomes.
 For example, organizations may or may not create usable EHR
configurations in patient examination rooms, devote sufficient resources to
EHR training, or make good choices about system configuration.
 Small medical practices are likely to have different resources and needs for
health IT than are large medical centers.
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THE PATIENT

 An organization that treats sick patients will perform poorly on patient

outcome measures unless comparisons are adjusted for the population’s
burden of illness.
 A variety of methods for risk adjustment, such as case mix adjustment and
co-morbidity indices, have been developed and validated to more
appropriately compare quality outcomes across physicians or healthcare
organizations.
 Other patient-specific characteristics such as health literacy, patient
engagement, and attitudes toward health IT may also be relevant.
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PROCESS

 In the Triangle Model, processes with the potential to affect quality and
safety outcomes of health IT connect the points of the triangle.
 Provider technology processes only when a technology is used as intended
can relevant quality outcomes be expected.
 It is thus important to assess the actual usage of the relevant features,
which is likely to vary at the level of the individual physician according to
usability and perceived usefulness, integration into clinical workflow and
task technology fit and training on the system.
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MODEL APPLICATION AND VALIDATION

 The Triangle Model specifies the predictor variables that should be

captured in order to explain quality or safety outcomes of health IT, but it
does not specify how these variables should be measured.
 The model can be applied to a variety of health IT evaluations.

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RESEARCH OBJECTIVES

 To examine the individual factors that affect nursing documentation

 To assess organizational factors influence proper nursing documentation.
 To identify the socio-cultural factors that contributes to effective
documentation.
 To assess the accuracy and quality of nursing documentation.
 To determine the efficiency of communication among nurses.

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