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UBC Theses and Dissertations

Nurses' use of iPads for clinical documentation : a usability study Ho, Wai Yu


Background/Purpose: Handheld devices are becoming increasingly prevalent in healthcare settings; however, few studies have examined the use of handheld devices for clinical documentation in the acute care setting. The purpose of this study was to investigate how nurses use the iPad for clinical documentation in the acute care setting. Methods: End user usability testing with think-aloud protocol was performed in a laboratory environment. Nurses who worked on an orthopedic surgery unit that use electronic clinical documentation were given a fictitious patient scenario with seven clinical documentation tasks that maximized the use of different functions of the iPad interface. A coding scheme was developed based on user and system behaviours defined by Dawson and Kushniruk. Results: Nine nurses participated in the usability testing. Nurses were in the nursing profession for an average of 13.2 years and in the study setting for an average of 11.5 years. All nurses reported that they had a desktop computer for personal use, and some nurses also owned an iPad (50%) and Smartphone (62.5%). Coded events were categorized into problems related to navigation, screen size, data entry, and login/logout. Navigational problems were mainly characterized by extra taps, mistaps, and the switch between tapping with finger and stylus. Nurses also had problems with the screen size when reading the font and icons, and selecting objects. Data entry problems were related to using a small external keyboard, and the mismatch with how data is saved between the iPad and the desktop computer terminals. Login/logout problems were significant barriers to clinical documentation as the process for both were time-consuming and required multiple steps. Conclusion: Improvements in clinical practice and the organization are warranted to enhance the use of iPads in the acute care setting, including education on the unit, and structural and technical supports from the organization. Organization supports include improving organizational infrastructure, incorporating stakeholder engagement and testing into the planning and implementation processes, and evaluating the compatibility of the operating systems employed by the handheld device and the organization. Further research in this area is warranted to better inform practice and future decision-making.

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