Acute care nurses’ perceptions of electronic health record use: A mixed method study

Strudwick, Gillian; Hall, Linda M.; Nagle, Lynn M.; Trbovich, Patricia

doi:10.1002/nop2.157

Cited by 35 publications

(34 citation statements)

References 41 publications

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“…Limited empirical evidence exists examining RNs' level of comfort with EDS usage. However, the study findings are congruent with the literature examining RNs' perceptions, reported concerns, satisfaction, barriers, and facilitators with EDS usage in practice (e.g., Black Book Market Research LLC, 2014;Saleem et al, 2015;Strudwick et al, 2018;Topaz et al, 2016). For example, Strudwick et al (2018) found the navigation, functionality, system performance, response time, and impact of the EDS on workload to negatively influence RNs' perception of the system usage in the acute care sector.…”

Section: Reasons For Comfort/discomfortsupporting

confidence: 82%

“…However, the study findings are congruent with the literature examining RNs' perceptions, reported concerns, satisfaction, barriers, and facilitators with EDS usage in practice (e.g., Black Book Market Research LLC, 2014;Saleem et al, 2015;Strudwick et al, 2018;Topaz et al, 2016). For example, Strudwick et al (2018) found the navigation, functionality, system performance, response time, and impact of the EDS on workload to negatively influence RNs' perception of the system usage in the acute care sector. Furthermore, a study conducted by Topaz et al (2016) noted that the identified issues related to the technological and organizational/environmental characteristics contributed to RNs' low satisfaction with the EDS in practice.…”

Section: Reasons For Comfort/discomfortsupporting

confidence: 82%

“…Despite the noted benefits of EDS, which are used for managerial (i.e., scheduling and referral) and point of care documentation, there have been reports of registered nurses' (RNs) negative experience, low intention, satisfaction, and discomfort with EDS usage at the point of care, in acute and home care sectors internationally (Hsiao & Chen, 2016;Stevenson, Nilsson, Petersson, & Johansson, 2010;Topaz et al, 2016) and nationally (Strudwick, McGillis-Hall, Nagle, & Trbovich, 2018). In addition, RNs have reported developing workarounds to address negative experiences (resulting from poor and nonfriendly system design and limited functionality) and to accommodate EDS usage in practice (Rathert, Porter, Mittler, & Fleig-Palmer, 2017;Ser, Robertson, & Sheikh, 2014).…”

Section: Introductionmentioning

confidence: 99%

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A Qualitative Content Analysis of Nurses’ Comfort and Employment of Workarounds With Electronic Documentation Systems in Home Care Practice

et al. 2019

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Background Electronic documentation systems have the potential to assist registered nurses with timely access to patient health- and care-related information. Registered nurses are the largest users of electronic documentation systems; however, limited evidence exists about their comfort with electronic documentation system usage and the types of workarounds developed within the context of home care. Aim To explore home care registered nurses’ comfort with electronic documentation system usage and identify the types and reasons for the development and implementation of workarounds. Methods A cross-sectional survey design was employed to collect quantitative and qualitative data. A total of 217 home care registered nurses participated in the survey. Quantitative data were analyzed using descriptive statistics. Qualitative data were analyzed using inductive content analysis. Findings: Individual (e.g., registered nurses’ technology-related experience), technological (e.g., electronic documentation system design) and organizational (e.g. training) characteristics influenced registered nurses’ comfort with electronic documentation system usage. Furthermore, workarounds stemmed from the technological characteristics of the electronic documentation system. Conclusion Findings highlight the need for assessing registered nurses’ level of comfort with electronic documentation system usage to inform training initiatives. Including registered nurses in the system design is advocated to ensure electronic documentation systems fit with the complexity of nursing practice, potentially enhancing registered nurses’ level of comfort and mitigating the development and employment of workarounds during system usage.

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Section: Reasons For Comfort/discomfortsupporting

confidence: 82%

Section: Reasons For Comfort/discomfortsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

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A Qualitative Content Analysis of Nurses’ Comfort and Employment of Workarounds With Electronic Documentation Systems in Home Care Practice

et al. 2019

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“…Another important finding was that nurses were concerned as to how they would record the volumes of information that they usually record. There is an emerging, but limited evidence base that has reported on the negative impact of EHR implementation on nursing practice when documenting crucial patient information (27,(71)(72)(73). Nurses have in the past had minimal influence in the design of systems (71).…”

Section: Discussionmentioning

confidence: 99%

Staff expectations for the implementation of an electronic health record system: A qualitative study using Normalisation Process Theory

McCrorie

Benn²,

Johnson³

et al. 2019

Preprint

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Background Global evidence suggests benefits of introducing electronic health record (EHR) systems to improve patient care. However, implementing EHR into healthcare organisations is complex and in the United Kingdom (UK), uptake has been slow. More research is needed to explore factors influencing successful implementation. This study explored staff expectations for change and outcome following procurement of a commercial EHR system by a large academic acute NHS hospital in the UK. Methods Qualitative interviews were conducted with 14 members of hospital staff who represented a variety of user groups across different specialities within the hospital. The four components of Normalisation Process Theory (Coherence, Cognitive participation, Collective action and Reflexive monitoring) provided a theoretical framework to interpret and report study findings. Results Health professionals had a common understanding for the rationale for EHR implementation (Coherence). There was variation in willingness to engage with and invest time into EHR (Cognitive participation) at an individual, professional and organisational level. Collective action (whether staff feel able to use EHR) was influenced by context and perceived user-involvement in EHR design and planning of the implementation strategy. When appraising EHR (Reflexive monitoring), staff anticipated short and long-term benefits. Staff perceived that quality and safety of patient care would be improved with EHR implementation, but that these benefits may not be immediate. Some staff perceived that use of the system may negatively impact patient care. The findings indicate that preparedness for EHR use could mitigate perceived threats to the quality and safety of care. Conclusions Health professionals looked forward to reaping the benefits from EHR use. Variations in level of engagement suggest early components of the implementation strategy were effective, and that more work was needed to involve users in preparing them for use. A clearer understanding as to how staff groups and services differentially interact with EHR as they go about their daily work was required. The findings may inform other hospitals and healthcare systems on actions that can be taken prior to EHR implementation to reduce concerns for quality and safety of patient care and improve the chance of successful implementation.

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“…In fact, this increased use of ICT has led to frustration among managers due to lack of education on the technology and the overwhelming amount of technological communication, such as email, that they receive (Kalman & Ravid, ; Misner, ). Nurse managers are also responsible for guiding staff nurses as they use and adopt new technologies, as staff nurses have reported dissatisfaction with ICT, including the lack of functionality, increased workload and lack of training (Strudwick, McGillis Hall, Nagle, & Trbovich, ; Topaz et al, ).…”

Section: Introductionmentioning

confidence: 99%

Perspectives of nurse managers on information communication technology and e‐Leadership

et al. 2019

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Aim We sought nurse managers’ perspectives on challenges and opportunities with technology and how it may influence communication and leadership. Background e‐Leadership is a conceptual framework used to understand and teach organisational leaders about the application of technology to leadership. Technology is integral to leadership, yet little is understood about how nurse managers may use this technology and how they negotiate the complexity of the multiple communication systems currently in use. Methods Sixteen nurse managers from individual hospitals within a large US healthcare system participated in qualitative open‐ended interviews and focus groups. Results Four themes emerged from the qualitative data regarding the nurse managers’ perspectives of e‐Leadership and their use of information and communication technologies: (a) Can't live without it, (b) Too much, too many, (c) Poor onboarding education and (d) Difficulty maintaining virtual relationships. Implications for Nursing Management Effective and safe patient care is dependent on multiple technology applications that require significant knowledge and practice. Nursing leadership may consider the need for more supported mentorship, and engaging programs to educate nurse managers about the dozens of applications required to effectively manage and lead. For technology to be used to its full potential it should be designed with nursing involvement.

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Acute care nurses’ perceptions of electronic health record use: A mixed method study

Cited by 35 publications

References 41 publications

A Qualitative Content Analysis of Nurses’ Comfort and Employment of Workarounds With Electronic Documentation Systems in Home Care Practice

A Qualitative Content Analysis of Nurses’ Comfort and Employment of Workarounds With Electronic Documentation Systems in Home Care Practice

Staff expectations for the implementation of an electronic health record system: A qualitative study using Normalisation Process Theory

Perspectives of nurse managers on information communication technology and e‐Leadership

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