The role of organizational context and individual nurse characteristics in explaining variation in use of information technologies in evidence based practice

BACKGROUND There is growing awareness of the role of information technology in evidence-based practice. The purpose of this study was to investigate the role of organizational context and nurse characteristics in explaining variation in nurses' use of personal digital assistants (PDAs) and mobile Tablet PCs for accessing evidence-based information. The Promoting Action on Research Implementation in Health Services (PARIHS) model provided the framework for studying the impact of providing nurses with PDA-supported, evidence-based practice resources, and for studying the organizational, technological, and human resource variables that impact nurses' use patterns. METHODS A survey design was used, involving baseline and follow-up questionnaires. The setting included 24 organizations representing three sectors: hospitals, long-term care (LTC) facilities, and community organizations (home care and public health). The sample consisted of 710 participants (response rate 58%) at Time 1, and 469 for whom both Time 1 and Time 2 follow-up data were obtained (response rate 66%). A hierarchical regression model (HLM) was used to evaluate the effect of predictors from all levels simultaneously. RESULTS The Chi square result indicated PDA users reported using their device more frequently than Tablet PC users (p = 0.001). Frequency of device use was explained by 'breadth of device functions' and PDA versus Tablet PC. Frequency of Best Practice Guideline use was explained by 'willingness to implement research,' 'structural and electronic resources,' 'organizational slack time,' 'breadth of device functions' (positive effects), and 'slack staff' (negative effect). Frequency of Nursing Plus database use was explained by 'culture,' 'structural and electronic resources,' and 'breadth of device functions' (positive effects), and 'slack staff' (negative). 'Organizational culture' (positive), 'breadth of device functions' (positive), and 'slack staff '(negative) were associated with frequency of Lexi/PEPID drug dictionary use. CONCLUSION Access to PDAs and Tablet PCs supported nurses' self-reported use of information resources. Several of the organizational context variables and one individual nurse variable explained variation in the frequency of information resource use.