JMIR Publications

ABSTRACT

Background:

The impact of Computarized Critical Care Information Systems (CCIS) on clinical care in intensive care units (ICUs) and the job satisfaction of ICU staff can range from positive to negative. Key factors influencing these effects include the usability of the Information Technology (IT) system and the level of training provided. Resistance may arise due to increased control imposed by the system and a lack of participation. The usability of CCIS and factors related to co-determination in its use have not been thoroughly examined.

Objective:

The study investigated barriers to using CCIS to provide actionable recommendations for manufacturing companies and hospitals. It focused on known usability factors while incorporating open feedback from current users to uncover new insights and identify additional usability factors not previously documented in the literature.

Methods:

Ten semi-structured qualitative interviews lasting one hour each were conducted with ICU personnel from three ICUs within a German university hospital (four nurses and six doctors), during which the CCIS was also assessed collectively. The interviews were recorded, transcribed, coded using MAXQDA, and analyzed based on content structure (both deductive and inductive approaches were applied).

Results:

A total of 86 distinct usability issues were identified and categorized into seven main groups and 22 subgroups. Of particular importance were issues such as unclear information presentation, especially for medication, overly lengthy or small interaction steps in documentation, missing or scattered information across sections, redundant data entry requirements, and slow system speed. Additionally, other challenges associated with system usage were classified under training, co-determination, perception feeling constrained, adherence to standard operating procedures (SOP), and changes in processes. The participants in the study highlighted that the level of contentment with the system has a direct influence on job satisfaction.

Conclusions:

CCIS usability greatly influences satisfaction with the IT system, affecting outcomes. Enhancing CCIS usability requires ongoing user testing and transparent employee involvement. Adequate training and SOP implementation are crucial. Successful implementation demands financial and temporal investments for organizational frameworks and feedback mechanisms.