Addressing Public Health Nurse Well-Being through Health Information Technology in Coos, Crook, and Jefferson Counties

Public Health | Coos, Crook, & Jefferson Counties, OR


While technology may be an increased stressor for nurses who work in a the hospital setting, the opposite may be true with public health home visiting nurses who have limited access to technology.  Our public health nurses indicated that they need access to over 100 forms, screens, assessments, and other tools and it is not practical to bring all of them out into the field. Our nurses also indicated that having the flexibility to chart while out in the field would reduce documentation stress by avoiding the reliance on one’s memory and need to return to the office between visits to document (some locations are 1 ½ hour drive from the office). Our nurses have indicated that in Oregon, the historically reduced timeframe for charting completion from 10 days to 2 days – regardless of being a weekend or holiday, creates pressure that would be partially relieved by initiating required documentation on the spot while in the field. Our nurses experience secondary trauma due to the long-term relationships with at-risk clients and crises. Nurses have to balance helping increasingly acute social, behavioral, and health crises in families against the expectation of completing paperwork, resulting in dissatisfaction with the job and burnout. Our nurses hypothesize that being able to promptly address a client’s needs reduces the stress and loss of control experienced by a nurse when confronted by a client in crisis. While a tablet will not solve all our nurses’ identified stressors, our nurses have indicated that they will feel a greater sense of control over their workload with this tool. A nurse focus group was convened to identify possible solutions of previously identified stressors by the nurses. A subsequent survey was completed to rank the interventions generated from this focus group. Qualitative interviews were completed with staff to further broaden the understanding of the stressor and the nurse-identified solutions.  This project focuses on the highest-ranked modifiable solution identified from nurses: reducing paperwork/charting by converting to tablets for use in the field. Unlike developing countries, there appears to be a scarcity of studies in the United States regarding public health nurses and other community health workers using tablets in the field. We hypothesize that with a relatively small investment, there will be reduction of stress in the community and public health workforce in Oregon.