20.500.12556/DKUM-92608 Skrb za pacienta in tehnološka kompetentnost pri uporabi elektronskega zapisa zdravstvene nege v bolnišničnem okolju Caring for patient and technological competency by using the electronic nursing record system in a hospital setting Uvod: Za zagotavljanje kakovostne in varne obravnave je poleg skrbi za pacienta pomembno tudi dokumentiranje obravnave. Učinkovitost elektronskega zapisa zdravstvene nege (EZZN) je pomemben element pri prepoznavanju in obravnavi pacientovih potreb, vendar pa lahko pomanjkljiva tehnološka kompetentnost zaposlenih v zdravstveni negi privede do pretiranega osredotočanja na uporabo EZZN, kar lahko negativno vpliva na skrbno obravnavo pacienta. Namen doktorske disertacije je bil raziskati učinkovitost EZZN, skrbna ravnanja zaposlenih in tehnološko kompetentnost v zdravstveni negi ter ugotoviti povezave med njimi pri uporabi EZZN. Metode: Uporabili smo zaporedni pojasnjevalni načrt raziskav mešanih metod, izveden med zaposlenimi v zdravstveni negi v štirih slovenskih bolnišnicah, ki uporabljajo enak EZZN. Raziskava je potekala od julija 2021 do julija 2023. Pred glavno raziskavo smo izvedli pilotno raziskavo. Kvantitativne podatke smo zbrali s tremi validiranimi vprašalniki ter jih analizirali z uporabo metod opisne in sklepne statistike. Analiza literature in nato kvantitativnega dela raziskave je bila osnova za oblikovanja vodila za intervju v kvalitativnem delu raziskave, ker smo podatke zbrali z delno strukturiranimi intervjuji. Za analizo podatkov smo uporabili metodo utemeljene teorije. Kvantitativni in kvalitativni del raziskave smo združili v fazi integracije, analizirani kvalitativni rezultati so nam služili kot pomoč pri razlagi ali nadgradnji kvantitativnih rezultatov. Rezultati: Učinkovitost EZZN je statistično značilno pozitivno povezana s časom od začetka njegove implementacije v bolnišnično okolje (p < 0,05) in stopnjo zaznavanja tehnološke kompetentnosti v zdravstveni negi (p < 0,05). Zaznana tehnološka kompetentnost je pozitivno povezana z zaznavanjem skrbnih ravnanj v bolnišničnem okolju, kjer se uporablja EZZN (p < 0,05). V okviru kvalitativne raziskave smo oblikovali glavno kategorijo, sedem kategorij in petnajst podkategorij. Model je vključeval vzročne pogoje (pomanjkljiva učinkovitost EZZN), kontekstualne pogoje (vključitev EZZN v bolnišnično okolje) in posredne pogoje (obravnava pacienta), ki vplivajo na pojav pomanjkljivega dokumentiranja individualne in celostne obravnave. Oblikovali smo akcijske/integracijske strategije za obvladovanje tega pojava, ki vključujejo tehnološko kompetentnost, skrb za pacienta in dokumentiranje, z rezultati v obliki izboljšane osredotočenosti na uporabo EZZN pri skrbi za pacienta in dokumentiranju celostne obravnave. Po integraciji kvantitativnih in kvalitativnih podatkov smo identificirali pet komponent: (1) pomanjkljivosti pri implementaciji v bolnišničnem okolju, (2) prednosti in pomanjkljivosti uporabe EZZN, (3) učinkovitost EZZN, (4) tehnološko kompetentna uporaba EZZN za dokumentiranje individualne in celostne obravnave pacienta, (5) skrb za pacienta in dokumentiranje obravnave. Razprava in sklep: Uporaba EZZN v bolnišničnem okolju je razkrila tako prednosti kot pomanjkljivosti uporabe, ki so večinoma povezane s pomanjkljivo implementacijo EZZN. Sinergija med skrbjo za pacienta, tehnološko kompetentnostjo in učinkovitostjo EZZN je ključna za ustrezno dokumentiranje individualne in celostne obravnave pacienta. Vrzeli v teh komponentah lahko vodijo do pomanjkljivosti v obravnavi pacientov in nepopolnemu dokumentiranju z uporabo EZZN. Introduction: Besides caring for patients, accurate and thorough documentation of treatment is essential to ensure high-quality and safe care. The effectiveness of the electronic nursing record system (ENRS) is an important element in identifying and addressing patient needs. However, a lack of technological competency among nursing staff can result in an overemphasis on using ENRS, potentially compromising the quality of patient care. This PhD thesis aims to investigate the effectiveness of ENRS, the caring behaviours of nursing staff, and their technological competency, as well as to explore the relationships among these factors in the context of ENRS use. Methods: We employed a mixed-methods sequential explanatory design, conducted among nursing staff in four Slovenian hospitals that utilised the same ENRS. The research was conducted from July 2021 to July 2023. A pilot study was carried out before the main study. Quantitative data were collected using three validated questionnaires and analysed through descriptive and inferential statistics. A review of the literature and the results of the quantitative phase formed the basis for developing the interview guide used in the qualitative phase, during which data were gathered through semi-structured interviews. The grounded theory method was applied to analyse the qualitative data. In the integration phase, we merged the quantitative and qualitative findings, with the qualitative results supporting the interpretation and refinement of the quantitative results. Results: Perceived technological competency is positively associated with perceived caring behaviours in hospitals where ENRS are used (p < 0.05). In the qualitative research, we created a main category, seven categories, and fifteen subcategories. The model included causal conditions (lack of effectiveness of ENRS), contextual conditions (integration of ENRS in the hospital setting), and indirect conditions (aspects of patient treatment) that influence the occurrence of insufficient documentation of individual and holistic care. We have developed action/integration strategies focused on technological competency, patient care, and documentation to address this issue. These strategies resulted in improved attention to using ENRS in both patient care and the documentation of holistic care. Following the integration of quantitative and qualitative data, we identified five core components: (1) implementation gaps within the hospital setting, (2) strengths and weaknesses of ENRS use, (3) lack of ENRS effectiveness, (4) technologically competent use of ENRS to document individual and holistic patient care, and (5) caring for the patient and documentation of care. Discussion and Conclusions: The use of ENRS in the hospital setting has shown advantages and limitations, primarily arising from implementation challenges. The synergy between caring for patients, technological competency, and the effectiveness of ENRS is crucial for documenting individual and holistic patient care. Gaps in these components can lead to deficiencies in patient care and incomplete documentation when using ENRS. skrb za pacienta učinkovitost elektronskega zapisa raziskave mešanih metod tehnološke kompetence zdravstvena nega caring for patient electronic record efficiency mixed methods research technological competence nursing care true true false [C. Krel] Slovenski jezik Angleški jezik Doktorsko delo/naloga 2025-04-23 19:41:17 2025-10-20 14:05:04 2025-10-21 03:16:17 0000-00-00 00:00:00 2025 0 Maribor 0 0000-00-00 NiDoloceno NiDoloceno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 659.2:004:616-083(043.3) 253606403 DOK_Krel_Cvetka_2025.pdf DOK_Krel_Cvetka_2025.pdf 1 750E6596DC432CCF75A3DAC6231B0930 c5c34675bcec9a125486556b63914c11b829f0e665591706118396e6b5d08177 a49aeda8-a5cc-11f0-b90a-00155d000105 https://dk.um.si/Dokument.php?lang=slv&id=199768 Fakulteta za zdravstvene vede 0 0 0