Determinants of Point-of-Care Technology use among Health Care Workers Offering Services at Comprehensive Care Centres in Central Kenya
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Date
2024-11
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Kenyatta University
Abstract
The most sophisticated level of interaction between healthcare professionals and the information system is the POC approach taking place during clinical meetings. The POC strategy offers benefits HCW, the patients they serve, and the individuals tasked with overseeing and assessing their performance. In central Kenya, the health facilities have continued to use both paper systems alongside the EMR system despite having POC implementations. The objective of the study was to determine the elements that affect the utilization of Point-of-care services by healthcare professionals. The study's specific goals were to recognize the socio-demographic, organizational, technical, and financial elements, extent of clinical decisions features use and level of accuracy and consistency of automated indicator reporting in influencing POC technology use among CCC’s in Central region of Kenya. Descriptive cross-sectional design was utilized in this study. The study population included clinical officers, nurses, health records and information officers among other cadres offering services in the CCCs. The sample was determined using a multi-stage cluster sampling design, and EMR users at health facilities sampled based on population size. The sample size for health facilities was 102 and for system users it was 239 HCW. Data was collected using structured questionnaire in an in-person environment. The data gathered was inputted and examined using descriptive statistics, including percentages. Additionally, Inferential statistical methods such as the chi-square test and Fisher's exact test were utilized to establish correlations with the assistance of R software. The findings indicated that POC use was unaffected by the social demographic factors of healthcare workers, Age X2 (1, n=225)=0, p=1; by sex X2 (1, n=224)=0.507, for education level, p=0.317; for computer skills, the chi-square statistic was X2 (2, n=225)=0.038 with p=0.981; regarding profession, p=0.070; and for county, the chi-square statistic was X2 (4, n=225)=1.589 with p=0.791. The use of POC technology was significantly influenced by organizational elements including the availability of adequate workstations (p=0.0) and the decrease in patient wait times facilitated by EMR (p=0.012). The origin of financial resources for the upkeep of software and hardware had a significant impact on POC use w p=0.001. Furthermore, the application of EMR for the real-time assessment of client progress (p=0.001) and the reporting of data to KHIS (p=0.014) was observed to significantly impact the utilization of POC services. 71% of participants stated that the presence of CDS features in the EMR was enhancing the utilization of POC. Additionally, 72% expressed strong motivation to use POC technology because of its capability to automatically generate reports. The success of POC use was attributed to three main factors, with 44% emphasizing the importance of a dependable power supply, 24% stressing the need for sufficient and well-trained healthcare workers, and 17% pointing to the significance of standard and reliable EMR Systems. Recommendations include training for HCWs on EMRs, ensuring adequate workstations and power supply, and adopting standard EMRs for effective clinical decision support and reporting.
Description
A Research Thesis Submitted in Partial Fulfillment of the Requirement for the Award of the Degree of Master of Public Health (Monitoring and Evaluation) In the School of Health Sciences of Kenyatta University, November, 2024
Supervisors:
1.Mary W. Gitahi
2.George O. Otieno