Patient Safety Perspectives of Providers and Nurses: The Experience of a Rural Ambulatory Care Practice Using an EHR With E‐prescribing

Abstract

Concerns remain among providers and nurses regarding the use of EHR with eRx applications, although concerns differed between groups. Therefore, When EHR improvements are planned, it is important to consider the differing needs of the professionals who deliver care.

Blame the Patient, Blame the Doctor or Blame the System? A Meta-Synthesis of Qualitative Studies of Patient Safety in Primary Care

“…They looked at general practice computer systems [ 68 ], the use of electronic health records and e-prescribing [ 69 ], patient identifiers and identification at a walk-in centre [ 70 , 71 ], uncertainties in providing healthcare [ 72 ], safety systems in commercial organisations providing NHS primary care [ 73 ] and the introduction of an incident reporting system [ 74 ]. The studies were based in the UK [ 68 , 70 , 71 , 73 ], The Netherlands [ 72 , 74 ] and the USA [ 69 ]. Following appraisal, all were considered ‘acceptable’ in terms of quality of reporting of research methods, except for one which was considered ‘excellent’ [ 68 ].…”

“…The majority of the studies were ethnographic in nature, where the researchers carried out observations and interviews [ 70 – 74 ]. There was also an interview study with range of “key stakeholders” [ 68 ], and a focus groups study with healthcare providers [ 69 ]. No patients were interviewed in the studies in this subset.…”

The current state of e-prescribing: Implications for advanced practice registered nurses

“…The literature chosen (Table S1) included three literature reviews (Lapane, Quilliam, & Dore, ; Manchikanti, Whitfield, & Pallone, ; Odukoya & Chui, ), three systematic reviews (Clyne, Bradley, Hughes, Fahey, & Lapane, ; Gagnon, Nsangou, Payne‐Gagnon, Grenier, & Sicotte, ; Motulsky, Lamothe, & Sicotte, ), one review of federal regulation (Schneider & Schneider, ), four descriptive analyses (Gabriel et al., ; Hincapie et al., ; Joseph, Sow, Furukawa, Posnak, & Daniel, ; Westbrook et al., ), three surveys (Amirfar et al., ; Jariwala et al., ; Thomas et al., ), four qualitative interview studies (Abramson et al., ; Bergeron et al., ; Bramble et al., ; Grossman, Cross, Boukas, & Cohen, ), one cross‐sectional study (Cochran et al., ), one time‐motion study (Hollingworth et al., ), and two expert commentaries (Figge, Fox, & Tribble, ; Odukoya & Chui, ). Table S1 provides full details regarding the literature, including author, purpose, methods, results, and conclusions.…”

“…Bramble et al () interviewed two focus groups: 4 prescribers/providers and 12 nurses. The main query was how the EHR with eRx impacted the care delivery system.…”

“…Also, prescribers felt that eRx was slower, redundant, and inefficient, while nurses felt that eRx increased legibility and efficiency, and improved workflow and communication. It was concluded that the needs of all professionals involved with EHR and eRx require consideration (Bramble et al., ).…”