Research Activities, September 2013
Intensive care unit clinicians moderately satisfied with computerized provider order entry
Health Information Technology
Overall acceptance of a computerized provider order entry (CPOE) system by nurses in four hospital intensive care units (ICUs) increased significantly over time at 3 months and a year later, found a new study. For prescribing providers (physicians, nurse practitioners, physicians' assistants) in the same ICUs, acceptance of the CPOE system changed minimally over the same period. Nurse satisfaction increased from 48.6, on a 0–100 scale after 3 months of use to 56.8 after 12 months of use; for prescribing providers, it was 57.8 at 3 months and 57.3 at 12 months.
After 3 months' CPOE use, nurses were most satisfied with getting help when they had problems with order entry and with the system's reliability. However, they reported being most dissatisfied at this point with the time-consuming effects of CPOE and their lack of training. At 3 months, prescribing providers reported having greatest satisfaction with CPOE system reliability, the availability of support, and the CPOE training they received. They were least satisfied with the impact of CPOE on their work speed, the CPOE system response time, and the impact of the system on patient care.
At the end of 12 months, nurses' satisfaction was still greatest for the availability of support and system reliability, and they were most dissatisfied with the training they had received. Although the nurses still reported that CPOE did not save them time, it did not slow them down as much as at 3 months. For the prescribing providers, the level of overall satisfaction did not change significantly over time, but at 12 months they were much more positive about the impact of CPOE on patient care. Both groups wanted improved system usability, nurses wanted easier modification of orders and improved communication, and providers wanted improved ability to find specific information in the system.
The findings were based on data from a previously validated questionnaire on CPOE implementation administered at 3 months and 12 months after implementing the CPOE system at several ICUs at a large teaching hospital. The study was funded in part by AHRQ (HS15274).
More details are in "Change in end-user satisfaction with Computerized Provider Order Entry over time among nurses and providers in intensive care units," by Peter L.T. Hoonakker, Ph.D., M.Sc., Pascale Carayon, Ph.D., Roger L. Brown, Ph.D., M.S., and others in the March 2013 Journal of the American Medical Informatics Association 20(2), pp. 252-259.