Low system quality and job strain hamper information system benefits in nursing

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Abstract Background Health information systems (HIS) have been widely adopted in nursing to increase the efficiency and safety of patient care. Previous studies have shown that low HIS quality is a barrier to obtaining such benefits from HIS use. The association between HIS quality and HIS benefits has not, however, been studied taking into account the characteristics of the work environment, such as job strain. This study examined the joint associations of HIS quality and job strain with the perceived patient care-related benefits of HIS use in nursing. Methods Cross-sectional survey data of 2707 Finnish registered nurses were used to examine the associations of two indicators of HIS quality (ease of use and technical quality) and job strain with the benefits of HIS use. Missing data were addressed with multiple imputation and linear regression was used to examine the associations. All analyses were adjusted for age, gender, and employment sector. Results Together with the covariates, HIS quality explained 14% to 20% of the variance in the perceived benefits of HIS use. The additional variance explained by job strain was only 1%. HIS quality in terms of ease of use interacted with job strain in predicting HIS benefits. Nurses who found HIS difficult to use and experienced high job strain reported the lowest benefits from HIS use. By contrast, nurses who found HIS easy to use considered HIS beneficial for improving patient care even if they experienced high job strain. Conclusions The results suggest that healthcare organizations should focus on ensuring good HIS quality to improve patient care through HIS use in nursing. Exposure to job strain may intensify the association between low HIS quality and lower patient care-related benefits from HIS use. HIS with good quality seem to improve patient care even in a high-strain work environment. Key messages Nurses who work with low-quality health information systems and experience job strain perceive the systems least beneficial for improving patient care. High-quality information systems, by contrast, are perceived to improve patient care even in a high-strain work environment.

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