| Abstract | Background: We recently introduced an electronic charting system into an area of our NICU, as phase I of a proposed unit-wide system. To evaluate the system, and compare it with our conventional paper charting system, we administered a customer satisfaction survey to the users of the system at the end of the first phase. Methods: The Hewlett Packard CareVue 9000 system was installed in the most acute 8 bed room of a 52 bed tertiary referral NICU. All NICU nurses and respiratory therapists were given 4 hours of classroom training with the system; other users received on the job training after "go live." After the "go-live" date, no paper records were used in this room. After a 15-month trial period, satisfaction was surveyed among all users of the system, using a custom survey tool. Results: Overall response rate to the survey was 166/285 (58 percent). One hundred thirty four questionnaires were included in this analysis. The breakdown of respondents was 99 nurses, 27 physicians and 9 "others." Overall satisfaction with the electronic charting system compared with the conventional paper system was 48 percent satisfied vs. 52 percent not satisfied or undecided. Six variables were analyzed for their correlation with overall satisfaction: use of a PC at home; greater than 10 years experience in the NICU; professional discipline, MD vs RN or RT; frequency of use, less than 1X/week vs. greater or equal to 1X/week; and whether the system was used for retrieval of data or for other tasks, including documentation, care planning, or combinations of these. Multivariate correlation analysis showed the only significant factors influencing satisfaction were frequency of use at least 1X/week (p less than 0.01); and use of the system for retrieval of data alone as compared to documentation or multiple tasks (p less then 0.01). Conclusion: Overall user satisfaction was 48 percent when compared to paper flowsheets. This reflects the difficulty in introducing electronic charting into a busy NICU setting with high acuity. Two contributing factors were significant in the acceptance of this technology: frequency of use and complexity of the tasks required of the user. Acceptance of any new charting system can be difficult. Better acceptance of electronic charting in the NICU setting may be achieved by introducing it in less acute areas, encouraging a broader utilization, and insuring all users are exposed to it on a regular basis. |