Annotated bibliography- references must be published within 2 years. Identify
authors and their purpose as well as level of evidence. Present annotated bibliography with
3 categories.
Work from an outline:
- Specific aim and main findings:
a. The specific aim of this …(what type of article is it?) article is to….
b. Main findings include…
2.Strengths and weaknesses
a. Strengths include….
b. Weaknesses are…. - Opinion/Evaluation
a. In my opinion/as a future FNP ….
Annotated Bibliography
Kwak, S. Y., Kim, Y. S., Lee, K. J., & Kim, M. (2017). Influence of nursing informatics
competencies and problem-solving ability on nursing performance ability among clinical
nurses. Journal of Korean Academic Society of Nursing Education, 23(2), 146-155.
The aim of the research was to investigate the correlation between the competencies of
nurses on the nursing informatics and the ability of the nurses to carry out clinical tasks. The
main findings of the study indicate that competency of the nurses in nursing informatics has a
great impact on the skills and abilities of nurses in the clinical practice. Particularly, there was a
close association between the level of the nurses on informatics and the quality of care the nurses
offered to the patients.
ANNOTATED BIBLIOGRAPHY 2
One of the strengths of the study is that the study population is composed of nurses from
a clinical set up where the application of nursing informatics is carried out as part of patient care
approach. In addition, the clinical setting offers an appropriate nursing setting to examine the
competency of nurses in offering quality care. Specifically, the nurses were assessed on their
ability to carry out clinical and practical nursing interventions on patients admitted to the
respective units within the hospital. Furthermore, the study investigated the relationship between
the knowledge and skills that nurses possess and the level of their clinical competency, which is
the ultimate aim of the nursing practice, to offer quality nursing services.
The weaknesses that the study presents include the failure of the study to put into
consideration the other contributors to the competency of nurses to perform clinical nursing
cares. Some of these factors could include the number of the years of nursing practice, the level
of academic and professional training, and demographic factors including age and gender.
Therefore, the level of the nursing competency in the clinical practice of nursing care may not
have been as a result of nursing informatics competency solely. Additionally, the study only
focuses on the relationship between nursing informatics and clinical nursing competency but
does not cover other areas of nursing science such as research and education.
In my opinion, the study forms a basis to integrate nursing informatics with the clinical
nursing practice. Therefore, nursing training programs should emphasize the relationship
between nursing informatics and the clinical nursing skills and knowledge. Additionally,
continues nursing education for in-service nurses should emphasize the significance of nursing
informatics on the overall performance of nursing care.
ANNOTATED BIBLIOGRAPHY 3
Bakken, S., Cimino, J. J., & Hripcsak, G. (2016). Promoting patient safety and enabling
evidence-based practice through informatics. Medical care, 42(2), II-49.
The specific aim of this study was to find out the role of nursing informatics in enhancing
patient care and evidence-based practice in the clinical setting. The main finding of the study was
that nursing informatics has a great role to play towards enhancing the safety of the patients and
facilitating evidence-based practice. According to the results of the study, proper storage and
management of information concerning the procedure, the steps followed and the instruments to
be used contributes towards avoidance of errors and injuries to patients during clinical and
surgical procedures. In addition, the proper keeping and the use of patient information allow for
nurses and other healthcare workers to accurately identify patients to undergo certain treatments
and clinical and surgical procedures. In addition, the research found put that clinicians are less
likely to make errors in attending to patients when they had the proper knowledge and the
resources required to apply informatics in the practice of nursing science in the clinical setting.
The strength of the study is that it is conducted in a clinical setting where the level of the
evidence-based practice and the patient safety are practiced. Therefore, the practice of nursing
that is based on the evidence has been well evaluated. In addition, data on the level of the patient
safety can be assessed during the treatment and various surgical and local procedures performed
in the clinical setting. Additionally, the study focuses on paint safety, which contributes towards
patient satisfaction and elimination of suffering, which are the ultimate goals of carrying out
clinical nursing intervention.
The weakness of the study is that the research does not investigate the factors that are
affects by nursing informatics such the quality of the clinical patient care, which is the overall
ANNOTATED BIBLIOGRAPHY 4
aim of nursing care to patients. Additionally, the study does not address factors that affect
nursing informatics and that have an implication on evidence-based practice, for instance, the
level of technological advancement which universally affects the practice of nursing informatics
in the clinical setting.
Kaye, S. P. (2017). Nurses’ Attitudes toward Meaningful Use Technologies: An Integrative
Review. CIN: Computers, Informatics, Nursing, 35(5), 237-247.
The aim of this study was to find out the nurses’ view, acceptance and attitude towards
the use and implementation of medical technologies, as shown in various studies and thesis
dissertations in the United States of America. The study was conducted through reviewing
several other studies whose aim is related to this current study.
The main findings of the study were that, generally, nurses have a positive attitude and
thus acceptance towards medical technologies. In addition, the study found out that several
factors are responsible for the acceptance or rejection of a particular medical technology. To
begin with, the peer influence by fellow nurses on any new medical technology was cited as one
of the leading factors that determine whether nurses accept medical technology or not. In
addition, the efficiency and the effectiveness of the technology determined largely on the nurses’
attitude towards the acceptance, thus the use of a particular medical technology. The ability of
the medical technology to improve on the quality of the nursing care while at the same time save
time and workload to achieve the same goal was found to positively impact on the attitude of the
nurses towards the technology as part of the general nursing informatics. The attitude of nurses
towards medical technology is affected by the training of nurses on the use of the technology.
Nurses who had received training on the use of certain medical technologies were found to have
ANNOTATED BIBLIOGRAPHY 5
a positive attitude towards the technology, and the readily accepted it. On the other hand, nurses
who had received training on a certain medical technology resisted it implementation, primarily
because of lack of knowledge on its usage and anxiety related to the technology. I addition, the
length of nursing experience affected the level of acceptance and the attitude.
One of the strengths of the study is numerous previous studies were review relevant to
the topic. The wide range of the studies reviewed produced large sets of data that increased its
validity and reliability, with increased number and variety of the sources of the data.
Additionally, the study has divided the themes under which the study is carried out into; nurses
attitude to the medical technologies at the implementation, implementation, post-implementation
stages and the overall attitude of nurses toward medical technology. The division of the themes
allows for detailed and objective assessment of the nurses; attitude at various and respective
stages of medical technology application.
The weaknesses associated with the study are that it does not include the attitude of other
healthcare professionals and their respective contribution towards the attitude of nurses towards
medical technology. Healthcare services are interdisciplinary in the approaches and the role
played by other team members significantly influences the on the acceptance or rejection of
medical technologies by the nurses.
In my opinion, the study establishes an insight into the role medical technology plays in
the overall quality of nursing care. Specifically, the study highlights the significance that the
attitudes of nurses have on the implementation of medical technology and therefore, the
application and practice of nursing informatics in general. Therefore, the health system should
ANNOTATED BIBLIOGRAPHY 6
not only focus on committing resources to the practice of nursing informatics only but also deal
with the effect of the nurses’ attitude towards new medical technologies in the healthcare system.
Jones, N., & Neckman, C. (2018). Facilitating the Adoption of Electronic System in
Documentation. Alphen aan den Rijn: Lippincott.
The aim of this survey was to investigate the impact of end-user satisfaction on the
implementation of Procedure Flow sheets as part of wider application health informatics in
nursing care.
The main finding was that the level of satisfaction of the Procedure Flow sheet to the
nurses significantly affected the level of acceptance and thus the application of the technology in
the patient care. Additionally, the level of satisfaction to the nurses is affected by additional
factors. The factors that determined the end user level of acceptance that is the nurses, included;
the level of training on the use of the new medical technology, the nurses’ level of training and
the tie period of nursing practice experience.
One of the strengths of the study is that it utilizes an appropriate framework, the Davis
Technological Acceptance Tool. Based on the tool, the ease of the technology to use, its ability
to save time while using, its ability to improve the quality of care and the ability to store patients’
data safely and confidentiality are some of the factors that determine the satisfaction a medical
technology has on the nurses, the level of acceptance and therefore the ability to implemented.
One of the weaknesses of the study review is that the study population was composed of
geriatric patients in the geriatric care unit. Therefore, the results of the study may not reflect the
nurses’ satisfaction and the acceptance of the tool by nurses working in other different clinical
settings. In addition, the study only examined the level of satisfaction of nurses on the Procedure
ANNOTATED BIBLIOGRAPHY 7
Flow sheet technology. However, there are other several forms and types of medical
technologies whose characteristics and their usage are different from the Procedure Flow sheet
examined in this particular survey review. Therefore, the level of nurses satisfaction and this the
level of acceptance and the implementation may be limited in their generalization in the
application to other forms of medical technology as part of the process of applying and pursuing
nursing informatics.
As a future nurse practitioner, in my opinion, the study is reliable as pertain the
implementation of nursing informatics since the results are consistent with the results of other
related studies. Therefore, before the implementation of any nursing informatics technology,
factors affecting its application and thus its implementation should be well evaluated in order to
ensure that the features that facilitate its satisfaction to healthcare workers are maximized while
altering the factors that limit its user satisfaction and acceptance in the clinical setting.
Walker-Czyz, A. (2016). The Impact of an Integrated Electronic Health Record Adoption
on the Quality of Nursing Care Delivered.
The aim of the study was to investigate the impact of the adoption of integrated electronic
health record adoption on the level of the quality of the nursing services in the clinical setting.
The main finding of the study was that the overall quality of the nursing care increased after the
adoption of the integrated health records medical technology in the clinical nursing services. The
increase in the quality of the nursing care was evaluated by investigating the prevalence of some
hospital associated conditions such catheter-associated urinary tract infections. In addition, the
ANNOTATED BIBLIOGRAPHY 8
improvement in the quality of the nursing care was evaluated according to the view of the nurses
on the improvement of the nursing care after the implementation of the integrated electronic
health records system.
The strength of the study was that the systematic and relevant development of the concept
of healthcare informatics. The research builds up the initial goal of the whole healthcare system
to provide efficient health and the growing demand for healthcare services, specifically, the
emphasis on the quality of healthcare offered. In addition, the study also builds on the concept of
the increase in the size of the general population and the emergence of new diseases which are
complex and require intensive nursing care. The study builds on the basic aims of information
technology including; the need for safety and confidential way of storing and keeping patients’
information, the performance of clinical procedures within a short period of time in a timely
manner, accurate dissemination of patients’ information and information sharing amongst the
nurses.
The weaknesses of the study are that it does not put into consideration the factors that
affect the level of uptake, acceptance, and application of the information technology in nursing.
The study only concentrates on the overall impact of the information technology application, but
the impact may have been affected by the factors that impact the acceptance, attitudes of the
nurses on the technology and the overall acceptance of the information technology.
In my opinion, the study provides the basic need for information technology, that is, to
improve the quality of nursing care. Therefore, the study forms the basis of evaluating any
medical technology. Before any information technology is applied in healthcare, it should be
ANNOTATED BIBLIOGRAPHY 9
evaluated on its contribution to the ultimate aim of health informatics, which is to improve the
quality of healthcare.
Gomes, M., Hash, P., Orsolini, L., Watkins, A., & Mazzoccoli, A. (2016). Connecting
Professional Practice and Technology at the Bedside: Nurses’ Beliefs about Using an
Electronic Health Record and Their Ability to Incorporate Professional and Patient-
Centered Nursing Activities in Patient Care. Computers, Informatics, Nursing, 34(12), 578.
The aim of the study was to investigate whether there was an increase in the amount of
patient-centered care after the introduction of electronic health records system. The study
primarily reviewed the amount of time spend in patient-centered care before and six months after
the introduction of an electronic health records system.
The study found out ha the amount of time spends on carrying out manual documentation
before the introduction of the electronic health records system, reduced significantly six months
after the introduction of the EHRs.
The strength of the study is that it used the theory of Health Caring as the theoretical
framework, which is appropriate for a study that investigates the patient-centered care.
Additionally, the study specifically evaluated the number of time nurses spent while performing
patient-centered case like communicating to patients and finding out their preferences, practices
that are components of patient-centered care.
The weakness of the study is that it did not investigate the overall impact of the patient-
centered approaches to the overall quality of care to the patients and the patient’s satisfaction.
ANNOTATED BIBLIOGRAPHY 10
In my opinion, the findings of the study are significant in pointing out the reasons for
more implementation of the healthcare informatics. However, the study should not be used solely
since it does not clearly indicate the level of the quality of nursing after the introduction of
electronic health records.
Alenius, M., & Graf, P. (2016). Use of Electronic Medication Administration Records to
Reduce Perceived Stress and Risk of Medication Errors in Nursing Homes. CIN:
Computers, Informatics, Nursing, 34(7), 297-302.
The main objective of this study was to investigate the impact of the use of medication
administration tools on the stress experienced by the nurses and the errors associated with the
administration of drugs. The main findings were that there was a significant reduction in the
stress associated with medication error and the actual errors in the medication were also reduced.
The strength of the study was that there was it investigated a vital nursing procedure,
administration of medication. Errors in the administration of drugs by nurses can cause serious
complications that complicate the health of the patient. Additionally, the study chose the study
setting as care homes for the elderly. The setting is appropriate for the study since more care is
attached to correct medication to the elderly who are more sensitive to errors involving drug
administration. In addition, the study utilizes its response to the perceived errors as a result of the
stress experienced and also investigates the errors in the drug administration as recited in the
drug administration tool.
The weakness of the study is that the research was only based on elderly care homes.
Usually, there are no serious medical cases as compared to the hospital-based medical cases.
ANNOTATED BIBLIOGRAPHY 11
Therefore, the results of the study may not be applicable to the hospital-based care, where the
nursing workforce is faced with the increased workload.
In my opinion, the study investigates the impact of electronic medical records on a
significant aspect nursing care to patients. However, further studies should be conducted to
investigate the impact of electronic drug administration tools on the number of errors in the acute
and hospital-based setting.
Michelle, Laura, Onyinyechi, & Joanne. (2017). HIT Implementation: Implications for the
Nursing Home Workforce. San Francisco: UCSF Health Workforce Research Center.
This research aimed at identifying the reparation on the nursing stuff towards the
implementation of new health information technology in nursing care homes, and perceived
nurses’ benefits and challenges of the introduction of health informatics systems in the facilities.
The study found out that there was the minimal preparation of nurses prior to the
introduction of health information technologies. The nurses were not prepared for the use of
some of the devices and computer applications that were used in any new health information
technology. However, the stuff reported an improvement in the overall access, communication
and cohesion with other healthcare staff members after the introduction of the health information
technology. However, the study respondents and the data collected from the review studies
identified various reasons for resistance from the nurses towards the adoption of new health
information technology. Specifically, some type and forms of health information technology
frustrated the nurses due to poor internet connectivity, machine breakdown and poor user
friendly computer programmes and applications.
ANNOTATED BIBLIOGRAPHY 12
One of the strengths of the study are it combined both primary and secondary sources of
data. The primary sources of data are the nurses who were interviewed concerning their
perceived benefits of the new health information technology in the nursing care homes.
Additionally, the nurses were asked about the challenges that they perceived were associated
with the adoption of the new technology. The secondary data sources were reviews of previously
performed studies on the benefits and challenges associated with the adoption and the
implementation of h information technology. The secondary data sources identified the nursing
staff preparation prior to the introduction of the new health information technology.
The weakness of the study was that the study lacked enough and sufficient literature
review available for the nursing care homes within the United States. Therefore the literature
review forms studies on health care information technology were reviewed and the may have had
negative impacts on the validation of the previous data and the data collected during this study.
In my own opinion, and according to the data collected and analyzed during this study,
the implementation of health information technology has not been fully implemented. Therefore,
the findings of this study and other studies should be used as evidence of lack of advanced
implementation of that information technology in nursing health care homes. Additionally, more
research studies should be performed on the level of implementation of health information
technology in nursing care homes.
Al-Hawamdih, S., & Ahmad, M. M. (2018). Examining the Relationship between Nursing
Informatics Competency and the Quality of Information Processing. Cin: Computers,
Informatics, Nursing, 36(3), 154-159.
ANNOTATED BIBLIOGRAPHY 13
The aim of the research was to identify how nursing information technology influenced
the practice and the application of evidence-based practice involving nurses in an acute clinical
setting. The main finding of the study showed a close relationship between the level of
competency and exposure to nursing informatics and healthcare information technology and
level of the user to practice and apply the evidence-based nursing practice. Additionally, the
study found several factors associated with the use of health information technology and nursing
informatics n the clinical practice of nursing. The factors identified were; the level of computer
literacy, age, the length of nursing experience, and the level of training.
The strengths of the study were; the multihospital setting of the study, and the study of
the association between nursing informatics and evidence-based practice. Evidence-based
practice is a universal requirement for all the nurses and information technology is largely
dependent on the information technology for acquisition data, data management and
dissemination of information gathered from the data. The multihospital setting allowed for a
wide range of data sources, and thus minimized bias and enhanced the validation and reliability
of the data. Therefore, the data obtained can be generalized to several hospital settings and can
therefore be applied to many other health care setting to implement evidence based practice
through the use of appropriate information technology.
The weakness of the study was the restriction of the study to only acute nursing care
setting. Nursing informatics affects all nurses across multiple clinical, care settings and thus
applicable to several hospitals and health facilities.
In my own opinion, the study presents a basis on which nursing informatics should be
incorporated as part of the larger scope of evidence-based practice in nursing practice.
ANNOTATED BIBLIOGRAPHY 14
Campbell, E. M., Li, H., Mori, T., Osterweil, P., & Guise, J. M. (2018). The impact of
health information technology on work process and patient care in labor and delivery.
The aim of the study was to determine the effects of adoption and implementation of
health information technology on the delivery healthcare services. The findings of the study
indicated improved quality of nursing care in delivery and labor rooms. Specifically, the number
of activities of nurses as involved in offering the services to patients undergoing delivery
increased by a significant number. Therefore nurses were capable of spending more time in
offering care to the patient and not documentation
One of the strengths of the study was that it was based in a labor and delivery setting,
which is a high-risk area. Therefore, the data obtained from the study plays a significant role in
identifying the areas where health information technology can be most effective in terms of the
care offered to the patient. Additionally, the study investigated the amount of time that the nurses
spend with clients, a factor that indicates and leads to increased inures-patient interaction, thus
leading to improved quality of nursing care. In addition, the research compared research results
that were obtained before and after the implementation of information technology regarding the
number of time nurses append with patients as a process of offering individualized care.
The weaknesses of the study are that the impact of the information technology. However,
other impact indicators of the quality of nursing care such as the patient’s outcome after the
introduction of the health information technology were not used in the study. In addition, the
nurses’ self-reported perceived benefits regard of the quality of care after the introduction of the
health information has not been investigated. Furthermore, several studies that have been
performed to assess the effect of the health information system adoption have had different
ANNOTATED BIBLIOGRAPHY 15
settings, such as intensive care units, acute care units and geriatric and home-based care.
Therefore, the data on the literature review used in the study may not be appropriate to indicate
comparable results as those obtained from this study.
References
Alenius, M., & Graf, P. (2016). Use of Electronic Medication Administration Records to Reduce
Perceived Stress and Risk of Medication Errors in Nursing Homes. CIN: Computers,
Informatics, Nursing, 34(7), 297-302.
ANNOTATED BIBLIOGRAPHY 16
Al-Hawamdih, S., & Ahmad, M. M. (2018). Examining the Relationship between Nursing
Informatics Competency and the Quality of Information Processing. Cin: Computers,
Informatics, Nursing, 36(3), 154-159.
Bakken, S., Cimino, J. J., & Hripcsak, G. (2016). Promoting patient safety and enabling
evidence-based practice through informatics. Medical care, 42(2), II-49.
Campbell, E. M., Li, H., Mori, T., Osterweil, P., & Guise, J. M. (2018). The impact of health
information technology on work process and patient care in labor and delivery.
Gomes, M., Hash, P., Orsolini, L., Watkins, A., & Mazzoccoli, A. (2016). Connecting
Professional Practice and Technology at the Bedside: Nurses’ Beliefs about Using an
Electronic Health Record and Their Ability to Incorporate Professional and Patient-
Centered Nursing Activities in Patient Care. Computers, Informatics, Nursing, 34(12),
578.
Jones, N., & Neckman, C. (2018). Facilitating the Adoption of Electronic System in
Documentation. Alphen an den Rijn: Lippincott.
Kaye, S. P. (2017). Nurses’ Attitudes toward Meaningful Use Technologies: An Integrative
Review. CIN: Computers, Informatics, Nursing, 35(5), 237-247.
Kwak, S. Y., Kim, Y. S., Lee, K. J., & Kim, M. (2017). Influence of nursing informatics
competencies and problem-solving ability on nursing performance ability among clinical
nurses. Journal of Korean Academic Society of Nursing Education, 23(2), 146-155.
Michelle, Laura, Onyinyechi, & Joanne. (2017). HIT Implementation: Implications for the
Nursing Home Workforce. San Francisco: UCSF Health Workforce Research Center.
ANNOTATED BIBLIOGRAPHY 17
Walker-Czyz, A. (2016). The Impact of an Integrated Electronic Health Record Adoption on the
Quality of Nursing Care Delivered.