Purpose: The usability, user satisfaction, and impact of electronic nursing record (ENR) systems were investigated. Methods: This mixed-method research was performed as a time-motion (TM) study and a survey which were carried out at six hospitals between August and November 2013. The TM study involved 108 nurses from medical, surgical, and intensive care units at each hospital, plus an additional 48 nurses who served as nonparticipating observers. In the survey, 1879 volunteer nurses completed the Impact of ENR Systems Scale, the System Usability Scale, and a global satisfaction scale. Qualitative and quantitative analyses were performed. Results: The mean scores for the ENR impact, system usability, and satisfaction were 4.28 (out of 6), 58.62 (out of 100), and 74.31 (out of 100), respectively, and they differed significantly between hospitals (F=43.43, p < .001, F= 53.08 and p < .001, and F= 29.13 and p < .001, respectively). A workflow fragmentation assessment revealed different patterns of ENR system use among the included hospitals. Three user characteristics-educational background, practice period, and experience of using paper records-significantly affected the system usability and satisfaction scores. Conclusion: The system quality varied widely among the ENR systems. The generally low-to-moderate levels of system usability and user satisfaction suggest many opportunities for improvement.

while dozens more followed the proceedings live via Web streaming. With support from sponsors ESD Consulting and HIMSS, this year's SINI described new roles for clinicians and informaticists in using informatics tools to support patient-centered care across settings. In addition, experts in two think-tanks conducted during SINI explored ongoing challenges in interoperability and data analytics, focusing particularly on issues arising from patient-generated data and health information exchange across settings.National leaders in health informatics filled plenary sessions with a set of distinguished lectures. In the opening keynote address, Philip Fasano, executive vice president and chief information officer, Kaiser Permanente, described online tools that Kaiser members may use to manage their health and communicate with their providers.Martin Kohn, chief medical scientist, Care Delivery Systems, Jointly Health, opened day 2 with a discussion about big data and clinical decision support. Later in the day, participants had the opportunity to hear a follow-up presentation by Eric Siegel, professor, University of Maryland School of Medicine, about what must happen before Watson, IBM's super computer, can support bedside care.The focus shifted from big data to personal health management in a presentation by a representative of the Office of the National Coordinator for Health Information Technology (ONC). Ellen Makar, senior policy advisor, described initiatives ONC is undertaking to help individuals and families engage in reaching their health goals through the use of computer-based and mobile health applications.Molly McCarthy, chief nursing strategist, Microsoft Health and Life Sciences, opened day 3 by telling participants about new Microsoft initiatives in healthcare and personal health management.Finally, Patricia Flatley Brennan, professor of nursing and industrial engineering, University of Wisconsin-Madison, gave the endnote address, inviting participants to look at emerging technologies that will transform both the delivery of healthcare and personal health management.Interspersed with the distinguished lectures were 34 invited and peer-reviewed podium presentations offered in concurrent sessions. An additional 27 peer-reviewed poster presentations sparked lively discussions during the poster session.Participants also enjoyed networking at the Exhibitor Evening. In addition to the showcase of products and services aimed at nursing informatics, participants met the authors of popular nursing informatics texts at a book signing and got acquainted with colleagues they had been following on Twitter at a Tweet Meet.The essence of SINI remains the quality of the content, the expertise and generosity of the presenters, and the collegiality of the participants. We were honored to receive a large number of excellent abstracts. Abstracts were carefully reviewed and scored by the 16-member planning committee, and awards were given to the highest-rated abstracts for poster and podium presentations in the categories of r...

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