Research Aim and Questions: This research aims to develop a quality framework of an effective Online Help System (OHS) for a Nursing Information System (NIS). This involves the identification of the criteria for an effective OHS. The research questions are what content, structure, functions and aesthetics this OHS should have. The research will also provide guidelines about how to evaluate the usability of an OHS. To learn unfamiliar features or functions of a Nursing Information System (NIS), nurses need effective and efficient assistances. An OHS, which aims to bridge the gap between the complexity of a NIS and nurse-users’ need for simplicity, is one effective solution. However, systematic research on the design and evaluation of an OHS is not common. There is a lack of a comprehensive quality framework that could provide guidance on the design and evaluation of an OHS for a NIS. As nurses are important healthcare workers, their acceptance and usage of a NIS is important for the improvement of quality of healthcare data, it is imperative to conduct this research with strong potential to impact on the adoption of NIS by nurses. Research Methodology: Two phases of investigation were carried out. Guided by a grounded theory approach, we first proposed a quality framework of an effective OHS for a NIS. In order to prove the validity of this framework, an experiment was carried out in which an OHS for an authentic NIS (the Care Planning and Assessment Tool) was developed and evaluated. Various research methods were employed in collecting data, i.e. laboratory-based usability testing, focus group discussion and questionnaire survey. Results: The proposed framework was consisted of the five criteria (i.e. content, structure, functionality, aesthetics, and usability. The CPAT Online Help was designed according to the results of the needs assessment and the forty-three guidelines that reflect the quality indicators in the framework. The results of the heuristic evaluation of the CPAT Online Help shows that the help system highly reflect on the proposed framework. The results of the usability testing suggest that the usability of both online help and hard-copy help manual is similar (i.e. no significant group difference was found for the results of both laboratory testing and the answers to the user satisfactory survey between online help and hard-copy help manual). However, in the laboratory experiment, the overall performances of the participants who used the CPAT Online Help were obviously better than those of the participants who used the hardcopy user manual. In addition, the survey responses from the former were more positive than those from the latter. Discussion and Conclusion: The proposed quality framework and their indicators were validated and supported by our research results and findings. Our research suggested that 1) nurse users’ basic computer skills, knowledge about an NIS, knowledge about procedures of nursing documentation should be covered in an OHS; 2) function-oriented and task-oriented structure are the effective structures of an OHS; 3) table of contents, frequently ask questions, search engine and video demonstration are effective functions; 4) visual-effectiveness can facilitate a nurse-user’s problem solving 5) the indicators of the usability of an OHS is the 5Es: effectiveness, efficiency, error-tolerance, engaging and ease of learning.
