Nurses’ adoption of technology:application of Rogers’ innovation-diffusion model

[[abstract]]This qualitative study applied Everett Rogers’ innovation-diffusion model to analyze nurses’ perceptions toward using a computerized care plan system. Twelve nurses from three respiratory intensive care units in Taiwan voluntarily participated in a one-on-one, in-depth interview. Data were analyzed by constant comparative analysis. The content that emerged was compared with the model’s five innovation characteristics (relative advantage, compatibility, complexity, trialability, and observability), as perceived by new users. Results indicate that Rogers’ model can accurately describe nurses’ behavior during the process of adopting workplace innovations. Related issues that emerged deserve further attention to help nurses make the best use of technology. THE USE OF computers in patient care and documentation represents an innovative change and significant challenge for nurses. Traditionally, nursing as a discipline has been care oriented and not concerned with applying advanced information technology that may require nurses to make decisions and think critically about charting changes in patient condition using assessment forms, care plans, or documentation software. Modern nursing must take into consideration the explosion of new technology and find new and better ways to deliver care (Romano, 1990a, 1990b). Although nurses have long been using computer systems to order and look up laboratory tests, their motivation for using these systems and the outcomes/effectiveness of using them have seldom been reported. Because nurses represent the largest group of technology users in health care organizations, their perceptions of computer use are a key determinant in the successful implementation of a computer system (Hilz, 2000). The most frequently applied method for evaluating the successful implementation of computer systems in health care organizations has been to assess nurses’ attitudes toward computer use (Dennis, Sweeney, Macdonald, & Morse, 1993). Nurses were assumed to have negative attitudes toward computers, thus needing assistance with technology use. More recent studies have revealed that with the increasingly popular use of computers, nurses no longer have negative attitudes toward using them (Alpay & Russell, 2002; Dillon, McDowell, Salimian, & Conklin, 1998; Simpson & Kenrick, 1997). Nonetheless, barriers to technology adoption have been proposed (Sobol, Alverson, & Lei, 1999), and Lee (2000) advised that the success of technology innovation relies on the individual’s decision to adopt it or not. Lee (2000) therefore used a combination of Rogers’ innovation-diffusion model and technology acceptance concepts to develop an instrument for evaluating information systems. Unlike most nursing models that focus on four major concepts (person, environment, health, and nursing) (Fitzpatrick & Whall, 1989), Everett Rogers’ innovation-diffusion model emphasizes the process by which an innovation or new knowledge is accepted or rejected by a particular group or organization over time (Rogers, 1995). Studies have used Rogers’ model to examine the outcome of using innovations such as nursing interventions, standard of care, or quality of documentation (Landrum, 1998; Lekan-Rutledge, 2000; Pearcey & Draper, 1996; Zerwekh, Thibodeaux, & Plesko, 2000). Although researchers have recommended using Rogers’ model to explore the process of how nurses adopt technology in care delivery (Hilz, 2000; Romano, 1990a, 1990b), no study has focused on the process by which a computerized nursing care plan is adopted. This study examined the applicability of Rogers’ model, specifically users’ perceptions of an innovation’s characteristics, for analyzing nurses’ perceptions toward using a computerized care plan system and how they adopt this new technology. The underlying assumption of this study was that by identifying the major factors affecting nurses’ use of new technology, related administration or education strategies and programs could be better designed to assist nurses in this adoption process