An exploratory quantitative study, examining the attitudes, concerns and potential barriers of Clinical Nurse Specialists to the introduction of Standardised Documentation and the potential of introducing Electronic Patient Records, to the Palliative Home

摘要

Introduction : Healthcare delivery is infected with enormous inefficiencies. Poor utilisation of our most valuable human resource is one such inefficiency and inadequate coordination of care is another. These two inefficiencies combined, lead the researcher to examine if Clinical Nurse Specialist, employed in the Palliative Homecare Services, in the Republic of Ireland would be likely to embrace the introduction of Standardised Documentation and to explore the potential of introducing Electronic Patient Records into the Palliative Homecare Service in the Republic of Ireland. Methods : This study was undertaken in four parts. A literature Review was undertaken to examine the extent of work already carried out by other scholars in relation to this topic. The second part of this study included the Application for Ethical Approval from the Research Ethic Committee, Trinity College Dublin, without which this study would not have materialised. The third part of the study involved a survey of Clinical Nurse Specialists employed in the Palliative Homecare Service in the Republic of Ireland, by use of an anonymous electronic questionnaire. The fourth part of the study involved the anonymous data collection, the confidential analysis and thesis write-up. Results, Discussions and Conclusion : The results of this study have both theoretical and practical implications. On balance the CNSs who participated in this study are broadly in favour of a standardised approach to documentation and are willing to embrace Electronic Patient Records, as long as effective preparation and training is provided in advance. The study results suggest that, the CNSs employed in the PHS in the Republic of Ireland are a savvy workforce with good IT proficiencies. The findings identify the need for conscious efforts to be strategically built upon to ensure that the HSE fully implement their eHealth Strategy. Limitations : Lack of resources and time constraints prevented the researcher using a postal paper based questionnaire as the resource implications, in both time and money would outweigh the cost of using an online questionnaire facility. The study reached an actual 83.38% (n=151/180) of the census population. Of these potential participants the study achieved a response rate of 40% of the ‘sample’ of the subject group of interest. This is considered a limitation of the study as it reduces its generalisability. The researcher acknowledges that a mixed methods study may have gathered richer data if focus groups or interviews had been utilized. The researcher is aware that, by using an electronic questionnaire to determine participants’ attitudes to EPRs, may have marginalized those who are not computer literate, and thus identifies this as a limitation to the study. Suggestions for Future Research and Practice : This study initially highlighted the fact that a register does not exist of all the CNSs employed in Palliative Homecare in the Republic of Ireland. The researcher identifies this as a major administrative oversight and would advise that this should be addressed as a priority. The researcher recommends that a further study be carried out, using a paper based questionnaire which could be forwarded to all CNSs employed in Palliative Homecare in the Republic of Ireland.