Differential effects of electronic patient record systems for wound care on hospital-acquired pressure injuries: Findings from a secondary analysis of German hospital data.

Autor: Hübner UH; Health Informatics Research Group, Department of Business Management and Social Sciences, Osnabrück University of Applied Sciences, P.O. Box 1944, D-49009 Osnabrück, Germany. Electronic address: u.huebner@hs-osnabrueck.de., Hüsers J; Health Informatics Research Group, Department of Business Management and Social Sciences, Osnabrück University of Applied Sciences, P.O. Box 1944, D-49009 Osnabrück, Germany. Electronic address: j.huesers@hs-osnabrueck.de.
Jazyk: angličtina
Zdroj: International journal of medical informatics [Int J Med Inform] 2024 May; Vol. 185, pp. 105394. Date of Electronic Publication: 2024 Mar 05.
DOI: 10.1016/j.ijmedinf.2024.105394
Abstrakt: Introduction: Despite the improvements made in recent decades, the OECD regards hospital-acquired pressure injuries (HAPI) as high priority areas for actions to ensure patient safety. This study was aimed at investigating the degree of utilization of two types of electronic patient record systems for wound care on lowering HAPI rates. Furthermore, the effect of user satisfaction with the systems and perceived alignment with clinical processes should be studied.
Material and Methods: A regression analysis of post-stratified data from German hospitals obtained from the Hospital Quality Reports (observed/expected HAPI ratio) and the IT Report Healthcare was performed. The sample comprised 319 hospitals reporting on digital wound record systems and 199 hospitals on digital nursing record systems for system utilization and the subset of hospitals using a digital system for user satisfaction and process alignment.
Results: The study revealed a significant effect of hospital ownership for both types of systems and a significant interaction of ownership and system utilization for digital wound record systems: Only the for-profit hospitals benefited from a higher degree of system utilization with a lower HAPI ratio. In contrast, non-profit hospitals yielded a reversed pattern, with increasing HAPI rates matching an increased system utilization. User satisfaction (significant) and the perceived alignment of the clinical process (trend) of the digital nursing record system were related with lower HAPI ratios.
Discussion: These findings point to a differential effect of system utilization on HAPI ratios depending on hospital ownership, and they demonstrate that those users who are satisfied with the system can act as catalysts for better care. The explained variance was small but comparable to other studies. Furthermore, it shows that explaining quality care is a complex undertaking. Sheer utilization has no effect while a differential perspective on the facilitators and barriers might help to explain the patient outcomes.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024. Published by Elsevier B.V.)
Databáze: MEDLINE
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