Doctor of Philosophy
School of Nursing and Midwifery
Craswell, Alison Jane, A Grounded Theory examination of the factors that influence midwives when entering perinatal data: the theory of beneficial engagement, Doctor of Philosophy thesis, School of Nursing and Midwifery, University of Wollongong, 2014. http://ro.uow.edu.au/theses/4118
Healthcare documentation, traditionally consisting of paper medical records, is being migrated to electronic records at increasing speed worldwide. The movement to paperless environments is believed to increase data accessibility and create savings in the tighter fiscal environments of modern healthcare. Population health data sets are collected to monitor mortality and morbidity, leading to identification of areas of most significant need and professional practice deficiency. Perinatal data collection is one such data set and is mandated for collection on all mothers and their babies born Australia-wide. Movement to computerised collection of perinatal data in Queensland, Australia, is proposed to have improved accuracy and decreased the turnaround time of the availability of this dataset. Midwives collect and enter perinatal data across Queensland, utilising eHealth technology.
This research aimed to understand the factors that influence midwives interaction with the computer when collecting and entering perinatal data. A Grounded Theory methodology was utilised and in-depth interviews were conducted with fifteen participants resulting in the development of a substantive theory, The Theory of Beneficial Engagement. This theory is grounded in the data, with a core category of engagement informed by nine elements: accountability, valuing, adapting, perceived benefits, workload, software, shifting focus, knowledge and data entry along with their subsequent themes.
The Theory of Beneficial Engagement proposes that midwives who enter perinatal data into a computer do so in the face of elements which act as barriers to successful use. However, data analysis identified elements particular to some participants that were not seemingly present in others. Some of these midwives appeared to effectively overcome barriers to entering perinatal data, hence forming a beneficial engagement with perinatal data. Such beneficial engagement emerged via participants personally identifying a reward for the effort of entering perinatal data into the computer. The Theory of Beneficial Engagement purports that the optimisation of any, some, or all of the elements of engagement in order to overcome barriers to perinatal data entry, may lead to achieving more timely, complete and accurate perinatal data entry. Translation of this theory proposes that any computer system can have an identified, individual set of elements that work to either enhance or act as barriers to engagement with particular software. Identification of these elements for any system and its group of users as well as their resulting modification to an optimal state, may lead to users becoming beneficially engaged with the software system. In this way, The Theory of Beneficial Engagement is translatable to any mandatory use software operated by users to achieve workplace goals.
This theory adds to the body of knowledge by being the first study to explain midwives use of computerised perinatal data collection in Queensland. Recommendations are suggested for improvement to the design and functionality of software, as well as professional development for users on the value and benefit of perinatal data collection to the care of mothers and their babies. Complete and accurate perinatal data entry into the computer contributes to care assisting in it being of the highest standard.