Background: Contemporary forces are increasing the pressure on healthcare facilities to use information systems (IS) to achieve better outcomes. Among these forces, the increasing nursing shortage, the aging population, and the emphasis on patient safety are particularly important ones. The use of IS improves nurses' ability to make sound clinical decisions in a timely manner, eliminates the amount of time spent on clerical work, and gives nurses more time for direct patient care. Studies indicate that nurses still are reluctant to use IS in their work or avoid it. Yet there is little information about factors that facilitate IS use, nurses' perceptions of benefits, and satisfaction from IS use. This study aims to explore the relationships among inputs: individual characteristics (age, nursing education, and computer experience), organizational factors (user involvement in implementation and management support for the use of IS), process of nurses' IS use, and IS outcomes (benefits and satisfaction).

Methods: Donabedian's quality assessment model and Holzemer & Reilly's conceptual framework were used with a descriptive correlational cross-sectional design. A random sample of 540 staff nurses recruited from the Ohio Nurses Association mailed the study questionnaire. Data were analyzed using descriptive statistics and multiple regression analysis.

Nurses working in hospitals spend at least 50% of their time providing direct patient care and use at least one IS, to be included in the study.

Results: The rate for nurses' responses to the questionnaire was 37.22% (N = 201). The average age of the nurses was 48.49 +/- 9.14 years, and their average experience was 23.11 +/- 9.98 years. Most of the nurses were women (N = 186, 93%), and 36% had a BSN (N = 72), whereas 35.5% (N = 71) had an associate degree, and only 22% had a diploma in nursing. Nurses worked full time (N = 132, 65.7%), averaging 35.51 hours per week. They had about 9 +/- 4.21 years of computer experience at work, and 31% of them worked in critical care units. The use of IS was significantly explained by computer experience, user involvement, and management support. Nurses' benefits and satisfaction were significantly explained by IS use.

Conclusion: The results of this study will assist hospital administrators and nurses' leaders in changing and/or restructuring the appropriate work environment to enhance nurses' IS use and increase their satisfaction, thereby improving patient outcomes.

Acknowledgments: The authors thank Sigma Theta Tau International and Alumni at Frances Payne Bolton School of Nursing.