Attitudes of nursing staff towards Computerization: a case of two Hospitals in Nairobi, Kenya

Abstract

Aim: - This study aimed at determining the attitudes of nurses towards the use of computers and the factors that influence these attitudes. Background: - The health sector is faced with constant changes as new approaches to tackle illnesses are unveiled through research. Information, communication and technology have greatly transformed healthcare practice the world over. Nursing, being an integral part of the healthcare delivery system, is exposed continually to a repertoire of changes. It is a common practice for authorities to plan and institute changes in hospitals without regard for the feelings or views of the intended end users. Nurses have often found themselves compelled to adopt changes for which they had little or no contributions. This invariably bred resentment and resistance leading to slowed or unsuccessful realization of the intended change (Timmons, 2003). Variables such as age, educational level, years worked in nursing, computer knowledge and experience have been found to influence the attitudes of nurses towards computerization. Methods: - This was a cross sectional descriptive study to determine the attitudes of nurses towards the use of computers in their hospitals. One hospital (AKUH) had introduced use of computers while the other (KNH) had not. The respondents from AKUH were taken to be users while those from KNH non-users. The study was conducted in medical and surgical wards in both Aga Khan University Hospital (AKUH) and Kenyatta National Hospital (KNH) in Nairobi, Kenya. A convenience sample of 200 nurses filled the questionnaires. The response rate was 100%. Data was collected using a modified version of the Nurses' Attitudes Towards Computerization (NATC) questionnaire that was developed by Stronge and Brodt (1985). The study instruments were tested for reliability and validity. The reliability coefficient for the likert-type questions was a Cronbach alpha was 0.82 implying a high internal consistency. The data was collected over a period of two months between May 2011 and June 2011. Descriptive statistics were used to analyze the data. In addition, two nonparametric tests (Kruskal- Wallis Test and Mann Whitney U-test) were used to establish relationships between the variables. Results: - Seventy eight percent (n = 156) of all the participating nurses were from Kenyatta xii National Hospital (KNH) and the remanung 22% (n= 44) from the Aga Khan University Hospital (AKUH). Overall, the nurses in the two hospitals had a favorable attitude towards computerization. The total attitude scores for nurses at both hospitals was 73.53 (SD = 13.15) out of a maximum possible score of 100. The range of attitude scores for this sample was 34 to 100. The non-users had a significantly higher attitude score (mean = 74.56) compared to the users (mean = 69.86, Mann Whitney z =2.206, p = 0.0274). Majority of respondents (72.4%) totally rejected the suggestion that computers should be confined to non-nursing departments such as finance. A similar majority rebuffed the idea that nurses should never use computers. The age of nurses showed a statistically significant association with attitude towards computerization (Kruskal Wallis i = 13.29, p = 0.039). Gender did not significantly impact on their attitude towards computerization (Mann-Whitney z = 0.179, p = 0.86). Professional training significantly influenced the nurses' attitudes towards computerization (Kruskal Wallis i= 9.34, p = 0.025). Holders of bachelors' degrees (mean = 82.07) and higher diplomas (79.07) had the highest attitude scores. The duration of exposure to computers showed a significant association with attitude towards computerization (Kruskal Wallis i = 12.81, P = 0.025). Nurses with longer durations of exposure to computers (at least three years) at both hospitals were likely to have more positive attitudes than those with relatively shorter durations of computer use. Conclusion: - Generally, nurses have positive attitudes towards computerization. The findings further disclose that nurses with little or no experience in using computers in the places of work (non-users) and those from a hospital that had instituted use of computers (users) both had positive attitudes towards computerization. Interestingly, the non-users were more positive than the users. This information is important for the planning and implementation of computerization in the hospital as suggested in other studies. xiii