Information Systems Use Among Ohio Registered Nurses: Testing Validity and Reliability of Nursing Informatics Measurements Amany A. Abdrbo, RN, MSN, PhD C. Case Western Reserve University Frances Payne Bolton School of Nursing

Background Approximately 4.6% of the health care budget is spent on Information Technology (IT). Nurses are the largest member of the hospital workforce and they are continually urged to use information technologies to improve patient safety and quality. Little is known about human factors such as perceived benefits and satisfaction that are key to IT implementation success. Lack of appropriate measurement tools to evaluate the use and benefits of IT in nursing. Purpose The purpose of this pilot study is to assess the psychometric properties of IT measurement tools for use among nurses.

Input-Process-Outcome Based on Donabedian’ Quality Assessment Model 1 and Holzemer and Reilly’ Outcomes Model for Health Care Research 2. Theoretical Framework 1. Donabedian, A. (1988). The quality of care. How can it be assessed? JAMA : The Journal of the American Medical Association : JAMIA, 260(12), Holzemer, W., & Reilly, C. (1995). Variables, variability, and variations research: implications for medical informatics. Journal of the American Medical Informatics Association: JAMIA, 2(3), PROVIDER INPUTS  User Involvement  Management Support PROVIDER PROCESS Information Systems (IS) Use PROVIDER OUTCOMES  IS Benefits  IS Satisfaction

Methods Design: A descriptive correlational cross-sectional. Sample: A convenience sample of 62 nurses working in hospitals and enrolled in advanced nursing courses Inclusion criteria:  Spend at least 50% of their time providing direct patient care  Uses at least one information system in their work. Data Collection Procedure: Questionnaires were distributed during the class break time. Nurses were asked to return the questionnaires back to a return box placed in a convenient place.

VariableEmpirical Indicators# of Items Scale User Involvement User Involvement Scale (Doll & Torkzadch, 1990) (Adapted) 8likert scale ranging from (1) Not at all to (5) a great deal Management Support Management Support Scale (Igbaria, 1990) (Adapted) 6Likert scale ranging from (1) strongly disagree to (5) strongly agree IS UseIS Use Scale (Investigator developed) 7likert scale ranging from (0) never/almost never to (4) always/almost always IS BenefitsBenefit Scale (Investigator developed) 56Likert scale ranging from (1) strongly disagree to (5) strongly agree IS SatisfactionSatisfaction Scale (Calisir & Calisir, 2004) (Adapted) 1Likert scale ranging from (1) very dissatisfied to (5) very satisfiedInstruments

Sample CharacteristicsN % Gender Male Female Race African American46.5 White Asian69.7 Work Status Full-time Part-time1321 Other812.9 Sample CharacteristicsN % Informatics Courses Informatics Training Level of Education Associate degree11.6 Diploma degree58.1 BSN Practice doctorate11.6 MSN711.3 Other34.8 Results: Sample Characteristics

Sample CharacteristicsMSD Age (Years) Percentage of time spent providing patient care Years of experience in nursing Years of experience working in the hospital Hours of work/week Results: Sample Characteristics

VariableCronbach’ Alpha User Involvement 0.92 Management Support0.90 IS Use0.85 IS Benefits0.97 Results: Reliability

Results: Validity Validity was assessed by testing hypothesized relationships. As hypothesized, there was significant correlation between inputs (user involvement, management support), process (IS use), and outcomes (benefits, satisfaction).

.38**.46**.25*.32* IS Use IS Benefits IS Satisfaction User Involvement Management Support *p <.05. ** p <.01.

Conclusions In this preliminary study in nursing informatics, some instruments show psychometric evidence, while others have a low validity and still require testing among different samples to affirm their validity according to the Input-Process- Outcome framework.