Assessing the Level of Readiness for Computerized Health Management Information System Among Nurses in Kenyatta National Hospital, Nairobi, Kenya
Mucheneh, Olive Mirai
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Healthcare Organizations are now in the process of implementing computerized health management health information system (CHMIS) with a hope that they will improve on safety, efficiency and effectiveness of patient healthcare (Ammenwerth, 2004). More specifically, due to advances of technologies, the adoption of CHMIS is growing rapidly. CHMIS are believed to offer significant benefits in improving patient health care delivery (Thompson, 2005). Health care Organizations implement CHMIS, without knowing whether, nurses will be willing to adopt such systems. If nurses reject the new technologies, CHMIS implementation will not succeed, resulting to poor health care and wastage of resources. The main objective of this study was to assess the level of readiness for CHMIS among nurses in Kenyatta National Hospital (KNH). The specific objectives were to assess the level of readiness for CHMIS, to determine the influence of demographic characteristics influencing readiness for CHMIS, to determine the institutional characteristics influencing readiness for CHMIS, determine the influence of information technology (IT) skills on readiness for CHMIS. The research problem was studied with cross sectional descriptive design using both quantitative and qualitative techniques. The study was conducted at KNH with a sample of 313. The study used a self-administered questionnaire for the respondents, focus group and key informant interview guides for focus group discussion and key informant interviews. Standard package for social sciences (SPSS) version 19.0 was used for analysis. Descriptive and inferential statistics were computed. Results were presented in tables and in narration. The mean for level of readiness was 3.5 which was low. The study found that 110 (35%) were ready for CHMIS, while 203(65%) were not ready. The study showed a significant relationship between designation and readiness for CHMIS among nurses in KNH x2 (1) = 12.26, p = 0.000). However, there was no significant relationship between gender x 2 (1) = 0.01, p = 0.91; age x2 (2) = 3.87, p = 0.14; level of education x 2(1) =0.15, p =0.70; highest qualification x2 (1) = 3.34, p = 0.07; work experience x 2 (1) = 3.67, p = 0.05 and readiness for CHMIS among nurses. The study further showed a significant relationship between overall institutional characteristics x2 (1) = 41.69, p= 0.000 and readiness for CHMIS among nurses. The study showed a significant relationship between IT skills and readiness for CHMIS x2 (1) = 7.613, p = 0.006. Results from focus group discussion and key informant interviews indicated that the hospital has not trained nurses in IT, the top management has not communicated the IT strategy to nurses, and awareness and participation among nurses was lacking. System champions were also lacking among nurses as well as technical support. Further, KNH lacked sufficient infrastructure for CHMIS and the hospital has not carried any technology assessment to find out whether nurses were ready for CHMIS or not. The hospital information communication technology (ICT) master plan was still on draft. Based on these findings, the study recommends that; the top hospital management should fully assess nurses level of readiness and other requirements prior to implementing CHMIS, provide IT training to nurses, identify system champions among nurses, provide sufficient infrastructure for CHMIS implementation, and finalize the ICT master plan for possible implementation. The study recommended that future research could investigate which new constructs such as high innovativeness, low insecurity and discomfort could add to the explained levels of technology readiness (TR).