Entering a world of uncertainty: community nurses' engagement with information and communication technology

Achieving adoption, use, and integration of infor- mation and communication technology by health- care clinicians in the workplace is recognized as a challenge that requires a multifaceted approach. This article explores community health nurses’ en- gagement with information and communication technology as part of a larger research project that investigated the delivery of self-management support to people with chronic obstructive pul- monary disease. Following a survey of computer skills, participants were provided with computer training to support use of the project information system. Changes in practice were explored using action research meetings and individual semistruc- tured interviews. Results highlight three domains that affected nurses’ acceptance, utilization, and integration of information and communication tech- nology into practice; environmental issues; factors in building capacity, confidence, and trust in the technology; and developing competence. Nurses face individual and practice challenges when at- tempting to integrate new processes into work ac- tivities, and the use of participatory models to support adoption is recommended.