Impact of Adoption of a Comprehensive Electronic Health Record on Nursing Work and Caring Efficacy

Abstract

Nurses in acute care settings are affected by the technologies they use, including electronic health records. This study investigated the impacts of adoption of a comprehensive electronic health record by measuring nursing locations and interventions in three units before and 12 months after adoption. Time-motion methodology with a handheld recording platform based on Omaha System standardized terminology was used to collect location and intervention data. In addition, investigators administered the Caring Efficacy Scale to better understand the effects of the electronic health record on nursing care efficacy. Several differences were noted after the electronic health record was adopted. Nurses spent significantly more time in patient rooms and less in other measured locations. They spent more time overall performing nursing interventions, with increased time in documentation and medication administration, but less time reporting and providing patient-family teaching. Both before and after electronic health record adoption, nurses spent most of their time in case management interventions (coordinating, planning, and communicating). Nurses showed a slight decrease in perceived caring efficacy after adoption. While initial findings demonstrated a trend toward increased time efficiency, questions remain regarding nurse satisfaction, patient satisfaction, quality and safety outcomes, and cost.

Innovation in Utilizing Information Technology Systems in Improving the Quality of Nursing Services

“…While an EHR does contain the medical and treatment histories of patients, an EHR system is built to go beyond standard clinical data collected in a provider's office and can be inclusive of a broader view of a patient's care. EHRs can contain a patient's medical history, diagnoses, medications, treatment plans, immunization dates, allergies, radiology images, and laboratory and test results, allow access to evidence-based tools that providers can use to make decisions about a patient's care, automate and streamline provider workflow (8).…”

The Implementation of Electronic based Nursing Care Documentation to EFETEC; A Literature Review

“…However, after asking her, nurses only pay 35% of their time in a nurse station. It indicates that after applying EHR, they spend more time intervening and interacting with patients and their families (14).…”

“…Patients are unique individuals, and thus nurses must be able to provide holistic care according to patient needs. The use of EHR increases the focus of nurses on interacting with patients and families (14) . Communication to patients and families is essential to maintain a trusting relationship between patients and health workers.…”

Refinement, reliability and validity of the Time Capture Tool (TimeCaT) using the Omaha System to support data capture for time motion studies

“…Time and motion (T&M) study is a critical technique to assess nursing workflow in healthcare settings. (Hendrich, Chow, Skierczynski, & Lu, 2008;Lopetegui et al, 2014;Schenk et al, 2018;Yen et al, 2018).…”

“…In T&M study, an external observer captures data on the time and motion which represents duration of tasks and workflow with an analysis (Lopetegui et al, 2014;Zheng, Guo, & Hanauer, 2011). T&M study was originally intended to promote business efficiency, although it is also a useful method in healthcare organizations to improve workload and productivity of nurses (Burke et al, 2000;Hendrich et al, 2008;Lopetegui et al, 2014;Schenk et al, 2018;Yen et al, 2018;Yoon et al, 2015;Zheng et al, 2011).…”