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

Shiells, Kate; Holmerová, Iva; Šteffl, Michal; Štěpánková, Olga

doi:10.1080/17538157.2018.1496091

Cited by 26 publications

(24 citation statements)

References 38 publications

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“…EMRs intention to use by healthcare providers is an essential requirement to ensure that the expected benefits will be materialized and to predict the actual utilization of EMRs [ 22 ]. Evidences revealed that health professionals acceptance to the new system and the potential disruptions and changes that follow is one of the major barrier to implement EMR [ 23 – 25 ]. So, identifying the necessary prerequisites before the actual implementation of EMRs will help to improve the implementation status.…”

Section: Introductionmentioning

confidence: 99%

Intention to use electronic medical record and its predictors among health care providers at referral hospitals, north-West Ethiopia, 2019: using unified theory of acceptance and use technology 2(UTAUT2) model

Ahmed¹,

Bogale

Tilahun

et al. 2020

BMC Med Inform Decis Mak

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Background: Electronic Medical Records (EMRs) are systems to store patient information like medical histories, test results, and medications electronically. It helps to give quality service by improving data handling and communication in healthcare setting. EMR implementation in developing countries is increasing exponentially. But, only few of them are successfully implemented. Intention to use EMRs by health care provider is crucial for successful implementation and adoption of EMRs. However, intention of health care providers to use EMR in Ethiopia is unknown. Objective: The aim of this study was to assess health care provider's intention to use and its predictors towards Electronic Medical Record systems at three referral hospitals in northwest , Ethiopia, 2019. Methods: Institutional based cross-sectional explanatory study design was conducted from March to September among 420 health care providers working at three referral hospitals in northwest Ethiopia. Data were analyzed using structural equation model (SEM). Simple and multiple SEM were used to assess the determinants of health care providers intention to use EMRs. Critical ratio and standardized coefficients were used to measure the association of dependent and independent variables, 95% confidence intervals and P-value were calculated to evaluate statistical significance. Qualitative data was analyzed using thematic analysis.

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Section: Introductionmentioning

confidence: 99%

Intention to use electronic medical record and its predictors among health care providers at referral hospitals, north-West Ethiopia, 2019: using unified theory of acceptance and use technology 2(UTAUT2) model

Ahmed¹,

Bogale

Tilahun

et al. 2020

BMC Med Inform Decis Mak

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“…A recent survey among nurses also suggested an association between variations in use of standardized terminologies and poor user-friendliness, with seeing electronic health records as less bene cial (31). An integrated review investigating electronic patient records as facilitator of care in nursing homes, stated a need for a focus on the type of documentation system used, and further for research among end users to identify the optimal system characteristics for use in this type of setting (32). A scoping review (33) also pointed to a general lack of research into patient safety and patient safety culture in nursing homes, and in residential care homes in particular.…”

Section: Discussionmentioning

confidence: 99%

Improving the Quality of Nursing Documentation at A Residential Care Home: A Clinical Audit

Moldskred¹,

Snibsøer

2020

Preprint

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Background: Quality in nursing documentation holds promise to increase patient safety and quality of care. While high-quality nursing documentation implies a comprehensive documentation of the nursing process, nursing records do not always adhere to these documentation criteria. The aim of this quality improvement project was to assess the quality of electronic nursing records in a residential care home using a standardized audit tool and, if necessary, implement a tailored strategy to improve documentation practice.Methods: A criteria-based clinical audit was performed in a residential care home in Norway. Quantitative criteria in the N-Catch II audit instrument was used to give an assessment of electronic nursing records on the following: nursing assessment on admission, nursing diagnoses, aims for nursing care, nursing interventions, and evaluation/progress reports. Each criterium was scored on a 0 - 3 point scale, with standard (complete documentation) coinciding with the highest score. A retrospective audit was conducted on 38 patient records from January to March 2018, followed by the development and execution of an implementation strategy tailored to local barriers. A re-audit was performed on 38 patient records from March to June 2019. Results: None of the investigated patient records at audit fulfilled standards for recommended nursing documentation practice. Mean scores at audit varied from 0.4 (95% confidence interval 0.3 - 0.6) for “aims for nursing care” to 1.1 (0.9 - 1.3) for “nursing diagnoses”. After implementation of a tailored multifaceted intervention strategy, an improvement (p < 0.001) was noted for all criteria except for “evaluation/progress reports” (p = 0.6). The improvement did not lead to standards being met at re-audit, where mean scores varied from 0.9 (0.8 - 1.1) for “evaluation/progress reports” to 1.9 (1.5 - 2.2) for “nursing assessment on admission”.Conclusions: A criteria-based clinical audit with multifaceted tailored interventions that addresses determinants of practice may improve the quality of nursing documentation, but further cycles of the clinical audit process are needed before standards are met and focus can be shifted to sustainment of knowledge use.

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“…Two further components, 'structure and content', were added by the authors in order to elicit opinions on the language and structure of the EPR forms. Under each component, specific questions were developed from evidence collated from the authors' prior research [21] and designed to elicit responses about the usability of the EPR for the task.…”

Section: Interview Guidementioning

confidence: 99%

“…Despite the potential benefits associated with this technology, the EPR has been described as a burden by nursing home staff, which has been linked with issues associated with its usability [20,21]. In this study, the ISO definition of usability as 'the extent to which a product can be used by specified users to achieve specified goals with effectiveness, efficiency and satisfaction in a specified context of use' [22] is adopted.…”

Section: Introductionmentioning

confidence: 99%

Staff perspectives on the usability of electronic patient records for planning and delivering dementia care in nursing homes: a multiple case study

Shiells

Diaz-Baquero

Štěpánková

et al. 2020

BMC Med Inform Decis Mak

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Background: The electronic patient record (EPR) has been introduced into nursing homes in order to facilitate documentation practices such as assessment and care planning, which play an integral role in the provision of dementia care. However, little is known about how the EPR facilitates or hinders these practices from the end-user's perspective. Therefore, the objective of this qualitative study was to explore the usability issues associated with the EPR for assessment and care planning for people with dementia in nursing homes from a staff perspective. Methods: An exploratory, qualitative research design with a multiple case study approach was used. Contextual Inquiry was carried out with a variety of staff members (n = 21) who used the EPR in three nursing homes situated in Belgium, Czech Republic and Spain. Thematic analysis was used to code interview data, with codes then sorted into a priori components of the Health Information Technology Evaluation Framework: device, software functionality, organisational support. Two additional themes, structure and content, were also added. Results: Staff provided numerous examples of the ways in which EPR systems are facilitating and hindering assessment and care planning under each component, particularly for people with dementia, who may have more complex needs in comparison to other residents. The way in which EPR systems were not customisable was a common theme across all three homes. A comparison of organisational policies and practices revealed the importance of training, system support, and access, which may be linked with the successful adoption of the EPR system in nursing homes. Conclusions: EPR systems introduced into the nursing home environment should be customisable and reflect best practice guidelines for dementia care, which may lead to improved outcomes and quality of life for people with dementia living in nursing homes. All levels of nursing home staff should be consulted during the development, implementation and evaluation of EPR systems as part of an iterative, user-centred design process.

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

Cited by 26 publications

References 38 publications

Intention to use electronic medical record and its predictors among health care providers at referral hospitals, north-West Ethiopia, 2019: using unified theory of acceptance and use technology 2(UTAUT2) model

Intention to use electronic medical record and its predictors among health care providers at referral hospitals, north-West Ethiopia, 2019: using unified theory of acceptance and use technology 2(UTAUT2) model

Improving the Quality of Nursing Documentation at A Residential Care Home: A Clinical Audit

Staff perspectives on the usability of electronic patient records for planning and delivering dementia care in nursing homes: a multiple case study

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