Nurses' Perceptions of the Impact of Electronic Health Records on Work and Patient Outcomes

ArticleinCIN Computers Informatics Nursing 26(2):69-77 · March 2008with132 Reads
Impact Factor: 0.72 · DOI: 10.1097/01.NCN.0000304775.40531.67 · Source: PubMed
Abstract

This study addresses community hospital nurses' use of electronic health records and views of the impact of such records on job performance and patient outcomes. Questionnaire, interview, and observation data from 46 nurses in medical-surgical and intensive care units at two community hospitals were analyzed. Nurses preferred electronic health records to paper charts and were comfortable with technology. They reported use of electronic health records enhanced nursing work through increased information access, improved organization and efficiency, and helpful alert screens. They thought use of the records hindered nursing work through impaired critical thinking, decreased interdisciplinary communication, and a high demand on work time (73% reported spending at least half their shift using the records). They thought use of electronic health records enabled them to provide safer care but decreased the quality of care. Administrative implications include involving bedside nurses in system choice, streamlining processes, developing guidelines for consistent documentation quality and location, increasing system speed, choosing hardware that encourages bedside use, and improving system information technology support.

    • "The self-reported heavy computer use by both the engineers and nurses is supported by existing literature and the many references to previous experiences mentioned during the interview portion of the study. While not a skill associated with traditional nursing, the ability to adapt and work quickly with a range of software has become a regular part of their profession (Kossman and Scheidenhelm, 2008). In light of this, the nurses' ability to complete the tutorial quickly and accurately is not surprising. "
    [Show abstract] [Hide abstract] ABSTRACT: This pilot study examines CAD software learning differences between a group of non-technical innovators (clinical nurses) and traditional CAD users (design engineers). This research was motivated by the rapid growth of digital fabrication methods and the proliferation of low cost, semi-professional CAD software, both of which have reduced prototyping barriers for innovators outside of professional design. The study's methodology consisted of (i) a pre-test survey to assess each subject's degree of computer usage and confidence in 3D modeling, (ii) the completion of a CAD tutorial on a laptop, and (iii) an interview to record each participant's impressions of the design experience. Based on a mixed-methods analysis of qualitative and quantitative data, the study showed that the nursing cohort had both the strong motivation and technical ability to learn CAD software. However, their profession enforces a low tolerance for ambiguity or time inefficiency, making the traditional engineering methods of " explore and learn " inappropriate. The output of this study will be used to assemble an extensive experimental curriculum for nurse innovators interested in medical device design.
    Full-text · Conference Paper · Jul 2015
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    • "The self-reported heavy computer use by both the engineers and nurses is supported by existing literature and the many references to previous experiences mentioned during the interview portion of the study. While not a skill associated with traditional nursing, the ability to adapt and work quickly with a range of software has become a regular part of their profession (Kossman and Scheidenhelm, 2008). In light of this, the nurses' ability to complete the tutorial quickly and accurately is not surprising. "
    [Show abstract] [Hide abstract] ABSTRACT: This pilot study examines CAD software learning differences between a group of non-technical innovators (clinical nurses) and traditional CAD users (design engineers). This research was motivated by the rapid growth of digital fabrication methods and the proliferation of low cost, semi-professional CAD software, both of which have reduced prototyping barriers for innovators outside of professional design. The study's methodology consisted of (i) a pre-test survey to assess each subject's degree of computer usage and confidence in 3D modeling, (ii) the completion of a CAD tutorial on a laptop, and (iii) an interview to record each participant's impressions of the design experience. Based on a mixed-methods analysis of qualitative and quantitative data, the study showed that the nursing cohort had both the strong motivation and technical ability to learn CAD software. However, their profession enforces a low tolerance for ambiguity or time inefficiency, making the traditional engineering methods of " explore and learn " inappropriate. The output of this study will be used to assemble an extensive experimental curriculum for nurse innovators interested in medical device design.
    Full-text · Conference Paper · Jul 2015
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    • "Nurses also perceive the introduction of EHRs to be positive, in that they can improve communication (through easier access to and legibility of patient information) and patient safety [20, 21, 25, 28, 29]. Conversely nurses have also reported that the introduction of an EHR can lead to problems with communication (as other clinicians don't read their notes) and can limit the amount of time available to spend with patients [21, 25]. Studies evaluating nurses' use of CDSS highlight the use of workarounds to ensure that the CDSS fit with nurse work process [14]. "
    [Show abstract] [Hide abstract] ABSTRACT: Purpose: To explore how nurses use an integrated Electronic Health Record (EHR) in practice. Methods: A multi-site case study across two hospitals in Kaiser Permanente Northern California. Non-participant observation was used to explore nurses' use of the EHR, while semi-structured interviews with nurses and managers explored their perceptions of the EHR and how it affected their practice. Data were analyzed thematically using codes derived deductively from the literature and inductively from the data. Results: Key themes arising from the analysis suggest that the EHR changed various elements of the way nurses practiced. Introducing the EHR was thought to have improved communication, ease of access to information and the safety of medication administration processes. At an organizational level, there was variability in how the EHR was used to support care documentation and initiatives to improve the quality of care provided by nurses. Conclusion: The EHR was perceived to improve efficiency, safety and communication by the majority of nurses who were interviewed. However, it is likely that a number of other factors such as individual nurse's characteristics and organizational culture influence how an EHR can be used effectively to improve outcomes for patients.
    Full-text · Article · Aug 2014 · Informatics for Health and Social Care
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