NIA 2017

Nurse manager risk information management for decision-making: A qualitative analysis

POSTER PRESENTATION – NURSING INFORMATICS AUSTRALIA CONFERENCE 2017

Introduction
Nurse managers hold pivotal positions in clinical settings, linking strategic and operational patient safety goals. Nurse managers also enact changes to practice based on information collected from the local ward environment with the aid of electronic risk management and incident reporting systems. Despite being key users of electronic risk management and incident reporting systems, little knowledge exists on nurse managers’ use and communication of information derived from these systems.

Aim
This qualitative study aimed to explore nurse manager information requirements, risk management practices, and influences on decision making when interacting with an electronic risk management and incident reporting system.

Method
Focus groups with eight nurse managers were conducted at a teaching hospital in Melbourne, Australia. A demographic questionnaire was also distributed. Inductive analysis of focus group data involved content analysis consisting of open coding, axial coding, and categorisation.

Results
Three themes were identified: navigating the system, relying on data, and communication and feedback. Nurse managers applied the data contained within the system to assess ward performance and make decisions around corresponding changes to practice. Decision making and information management approaches varied depending on whether the nurse manager investigated a single incident report or viewed summarised incident reports. Nurse managers faced individual and organisational barriers that prevented them from using the risk management and incident reporting system to its full potential. NM utilisation of electronic incident reporting and risk management software was influenced by a range of factors, including data inaccuracy impacting on information quality, lack of formalised user training, workarounds, and lack of organisational feedback. Our study responses revealed that none of the NM participants perceived themselves as possessing advanced computer skills. Interestingly, perceived confidence with using information technology did not increase with experience. There was also a lack of formal training on the incident reporting and risk management system specifically developed for NMs.

Conclusion
Formalised, structured software and information system training is recommended to improve efficiency and effectiveness of the risk management and incident reporting process, improve system user confidence and informatics skills, and fulfil nurse manager information requirements. The findings from this study will assist nursing and health care administrators in identifying ineffective practice and meeting nurse manager information requirements.

Key words
Decision making; hospital incident reporting; health information management; nurse administrators; patient safety; risk management

Tasneem Islam
Twitter: @neemet
BN(Hons) BCom RN
Deakin-Alfred Health Nursing Research Centre
School of Nursing and Midwifery
Deakin University
tislam@deakin.edu.au

Professor Alison M Hutchinson
Twitter: @ali_candlebark
PhD MBioeth RN
Centre for Nursing Research – Deakin University and Monash Health Partnership
School of Nursing and Midwifery
Deakin University
alison.hutchinson@deakin.edu.au

Professor Tracey K Bucknall
Twitter: @nursedecisions
PhD RN
Deakin-Alfred Health Nursing Research Centre
School of Nursing and Midwifery
Deakin University
tracey.bucknall@deakin.edu.au