Electronic Health Records in Long-Term Care: Staff Perspectives

Abstract

As long-term post-acute care (LTPAC) settings continue to increase their adoption of electronic health records (EHRs), it is important to learn from end users currently working with the technology to identify clinical implications and opportunities to improve systems and surrounding processes. This study utilized one-on-one interviews of direct care nurses ( n = 20) in a Midwest United States LTPAC setting to describe patterns of use, and areas to improve. The majority of respondents evaluated the EHR as easy to use, with a positive impact on quality of care, through efficiencies gained in communication with the care team. Staff responses outline desired modifications to the software, including fixes to data fields for more accurate medication administration and accurate reports on bowel protocol follow-up. Recommendations for LTPAC organizations are made regarding improved staff training on the EHR, and modifications to the EHR and related processes to improve quality of care and staff retention.

Electronic patient records as a tool to facilitate care provision in nursing homes: an integrative review

“…Furthermore, staff can quickly move from one resident's record to another, and multiple staff members are able to access records at the same time. 32 The processes of data distribution, storage, and retrieval were also described as more efficient, 5,19,31,32,[34][35][36] and the presence of a spellcheck saves time on proofreading. 37 Moreover, increased legibility has meant that staff are no longer forced to call doctors to clarify information that was previously handwritten, often causing time delays.…”

“…37 Moreover, increased legibility has meant that staff are no longer forced to call doctors to clarify information that was previously handwritten, often causing time delays. 35 Florczak et al 33 found that portable, handheld devices increased efficiency as they enabled staff to access and record data at the point of care. However, in a separate study, some staff felt that bedside technology was time-consuming, and as a result, they were found to be documenting at the end of their shift, and some documenting before care had been provided.…”

“…However, in a separate study, some staff felt that bedside technology was time-consuming, and as a result, they were found to be documenting at the end of their shift, and some documenting before care had been provided. 38 In several other studies, it was also suggested that electronic documentation systems do not necessarily save staff time 19,22,36,38 for reasons such as slow log-in processes, 9,14 difficulties with updating passwords, 35 and having to access each resident's record individually to chart information as opposed to using one paper chart for all residents. 37 In one home, the reporting of incidents required staff to document information into the electronic record and into a separate software system, increasing overall time spent on incident reporting.…”

“…37 In one home, the reporting of incidents required staff to document information into the electronic record and into a separate software system, increasing overall time spent on incident reporting. 35 Accountability Documented evidence of care is essential for managers to "assess whether care [. .…”

“…5 Using laptop computers that contain resident information during care planning meetings is also beneficial. 32 Furthermore, participants widely reported that electronic systems generate more accurate, complete, consistent, and legible information than paper records 5,13,14,19,31,[33][34][35][36]38 and highlighted that their quality does not deteriorate over time like paper records. 5 However, several studies indicated that electronic documentation systems may not necessarily facilitate care planning and assessment.…”