Technological Dynamics In Nursing And Their Challenges On Nurse Practicing Skills In Kenyatta National Hospital

Abstract

Title -Technological dynamics in nursing and their challenges on nurse practicing skills in Kenyatta national hospital. Background- Technological trends in nursing have affected the practice of nursing and have brought about versatility and challenges in adaptation. Kenyatta national Hospital (KNH) introduced the use of technology in nursing but the uptake seems to be slow. Certain challenges may be associated with incorporation of technology that has resulted in the slow uptake. Aim-This study aimed at establishing the trends in technology in the field of nursing and the challenges they pose on the practicing skills of nurses in KNH. Significance of the study-Incorporation of technology in nursing is inevitable and has been reported to improve efficiency of nursing service and patient care delivery. Nursing ICT in KNH was commenced in 2013 and up to now the uptake is low. Challenges brought about by technological advances within nursing practice causing low uptake and continued inefficiency of care delivery have not been studied. Study methodology-The study adopted a cross-sectional descriptive design. It was conducted in KNH, among qualified nurses who met the inclusion criteria. Simple random sampling technique was used to select 91 participants after applying fishers‟ formula. Purposive sample was used to select 5 nurse managers as key informants. A questionnaire focusing on demographic data, ways of utilization of technology in nursing, Influence of patient exposure to technology on nursing, challenges in technological skills application and the coping strategies was used to collect data. Interview Schedules were used on key informants. Analysis of data was done by verification and coding into an electronic system and use of Statistical Package for Social Sciences (SPSS) version 22.0. Statistical significance of the findings was analyzed using inferential statistics where association between variables was determined through chi square at confidence level of 95% at a p-value of 0.05. Presentation of the data was done using means, percentages and frequency distribution tables, pie charts and bar graphs. Study Results- The study found that EHR was the most commonly used technological application in nursing for billing (100%) and ordering of supplies (78%). The study found a significant relationship between nurses‟ perception of the impact of online patient-acquired health information and nurses‟ felt need for additional skills (Chi= 8.4, DF=1, P= 0.004). and also a significant relationship between nurses‟ rating of patient‟s level of online acquired health xvi information and nurse‟s application of technology (Chi= 8.2, DF= 3, P= 0.042). The study also found a significant relationship between the level of usage of EHR and the challenge of lack of computer navigation skills (Chi =16.8, DF=3, P=0.001) and the challenge of Non-conversance with computer vocabularies/language (Chi= 11.8, DF=3, P = 0.008). Conclusion and Recommendations- Study established that nurses who reported not having adequate technological skills reported more problems with computer navigation skills (Chi = 7.2, DF=1, P=0.007) and lacking necessary nursing application software in the system (Chi =9.1, DF=1, P=0.003). It also established that online patient acquired health information led to the need for more patient education skills (Chi= 8.4, DF=1, P= 0.004) and more use of technology by nurses. Therefore statistically technological dynamics had effect on nurse practicing skills at a confidence level of 95% p=0.005, rejecting the null hypothesis. Recommendations were that a survey on nurses level of skills in computers be done and be used as a guide for computer training. Also addressing of organizational, technological and user related challenges which could be done better through the establishment of a nursing informatics department to spearhead. Similar studies should also be done among nurses in different public and private hospitals and possibly compare the findings of these studies.