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