The impact of an integrated electronic health record on nurse time at the bedside: A pre-post continuous time and motion study

Walker, Rachel; Burmeister, Elizabeth; Jeffrey, Carol; Birgan, Sean; Garrahy, Elizabeth; Andrews, J. M.; Hada, Adriana; Aitken, Leanne M.

doi:10.1016/j.colegn.2019.06.006

Cited by 18 publications

(34 citation statements)

References 47 publications

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“…6,8,23 Nurses, who are considered super users in the EHR, should be involved in the implementation, evaluation, development, and decision making of the system. 24 There is a need for continuous updating of EHR systems and for nurses to stay up-to-date on EHR use. In this study, data on the time of the pandemic, which is an extraordinary situation, are presented.…”

Section: Discussionmentioning

confidence: 99%

“…3,6,21 It is essential to figure out how best to utilize and analyze such data to carry nursing interventions to a whole new level of care. 1,6,19,22,23 Nurses acknowledge the rationale for EHR and are willing to adopt this new technology and equipment 21,24 ; however, such systems should afford clear advantages such as reducing nursing workload and saving time for care. 8 To achieve a wider adoption of EHR systems, further support and training on the proper use of electronic documentation are still needed.…”

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confidence: 99%

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Barriers to Adoption of Electronic Health Record Systems from the Perspective of Nurses

Arıkan

Kara

Erdogan

et al. 2021

CIN: Computers, Informatics, Nursing

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This study report aimed to investigate the barriers to implementation of electronic health record systems from the perspective of nurses. The research data comprised responses from nurses working in a university hospital. Our data collection instruments were the Participant Information Form and EHR Nurse Opinion Questionnaire, which were developed by the researchers. Data analysis was presented as summary statistics, including mean values of variables, standard deviation, frequency, and percentages. A total of 160 nurses participated in the study. The mean age of participants was 30.94 ± 0.59 years, and 77.5% were university graduates. Barriers to adoption of the electronic health record system included high number of patients (82.8%), limited time (79%), lack of knowledge and skills for effective use of the system (22.9%), lack of user-friendly interface and inability to create a common language within the team (17.8%), and attachment to the traditional method (17.2%). Although most nurses thought that the electronic health record system offered some advantages, they reported that factors such as large numbers of patients, limited time, and lack of user-friendly interface hindered its adoption. Innovative strategies should be explored to develop user-friendly designs for electronic health records and to produce solutions for nursing shortages to increase the time allocated for patient care.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Barriers to Adoption of Electronic Health Record Systems from the Perspective of Nurses

Arıkan

Kara

Erdogan

et al. 2021

CIN: Computers, Informatics, Nursing

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show abstract

“…Providers perceived that retrieving and locating necessary information in EHRs was difficult [148] and took longer than expected, which also had a negative impact on their efficiency [34,40,45]. Clinicians expressed concerns and frustration regarding the slowness of systems [91,96,113] and the time-consuming nature of patient documentation using EHRs [23,34,38,40,43,44,58,145,154], with 81.8% of the respondents (physicians) in a survey agreeing that "to document on paper is faster than on the EHR" [39]. Another survey showed that 71% of the respondents (physicians) perceived an increase in time spent on patient documentation following the implementation of EHRs [17].…”

Section: Work For Healthcare Providers/staffmentioning

confidence: 99%

Effects of Electronic Health Record Implementation and Barriers to Adoption and Use: A Scoping Review and Qualitative Analysis of the Content

Tsai

Eghdam

Davoody

et al. 2020

Life

115

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Despite the great advances in the field of electronic health records (EHRs) over the past 25 years, implementation and adoption challenges persist, and the benefits realized remain below expectations. This scoping review aimed to present current knowledge about the effects of EHR implementation and the barriers to EHR adoption and use. A literature search was conducted in PubMed, Web of Science, IEEE Xplore Digital Library and ACM Digital Library for studies published between January 2005 and May 2020. In total, 7641 studies were identified of which 142 met the criteria and attained the consensus of all researchers on inclusion. Most studies (n = 91) were published between 2017 and 2019 and 81 studies had the United States as the country of origin. Both positive and negative effects of EHR implementation were identified, relating to clinical work, data and information, patient care and economic impact. Resource constraints, poor/insufficient training and technical/educational support for users, as well as poor literacy and skills in technology were the identified barriers to adoption and use that occurred frequently. Although this review did not conduct a quality analysis of the included papers, the lack of uniformity in the use of EHR definitions and detailed contextual information concerning the study settings could be observed.

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“…However, studies that reported documentation time on both electronic and paper charts showed a similar time range from 19 to 35% of total nurse activities. 20,[23][24][25]61 There are lack of reports quantifying log-based time spent on EHR by nurses, compared with physicians. A recently published paper described the first study of this kind to analyze active EHR time spent by nurse practitioners (N.P.)…”

Section: Mean Time Spent On Ehr Interaction Wasmentioning

confidence: 99%

Interaction Time with Electronic Health Records: A Systematic Review

et al. 2021

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Background The amount of time that health care clinicians (physicians and nurses) spend interacting with the electronic health record is not well understood. Objective This study aimed to evaluate the time that health care providers spend interacting with electronic health records (EHR). Methods Data are retrieved from Ovid MEDLINE(R) and Epub Ahead of Print, In-Process and Other Non-Indexed Citations and Daily, (Ovid) Embase, CINAHL, and SCOPUS. Study Eligibility Criteria Peer-reviewed studies that describe the use of EHR and include measurement of time either in hours, minutes, or in the percentage of a clinician's workday. Papers were written in English and published between 1990 and 2021. Participants All physicians and nurses involved in inpatient and outpatient settings. Study Appraisal and Synthesis Methods A narrative synthesis of the results, providing summaries of interaction time with EHR. The studies were rated according to Quality Assessment Tool for Studies with Diverse Designs. Results Out of 5,133 de-duplicated references identified through database searching, 18 met inclusion criteria. Most were time-motion studies (50%) that followed by logged-based analysis (44%). Most were conducted in the United States (94%) and examined a clinician workflow in the inpatient settings (83%). The average time was nearly 37% of time of their workday by physicians in both inpatient and outpatient settings and 22% of the workday by nurses in inpatient settings. The studies showed methodological heterogeneity. Conclusion This systematic review evaluates the time that health care providers spend interacting with EHR. Interaction time with EHR varies depending on clinicians' roles and clinical settings, computer systems, and users' experience. The average time spent by physicians on EHR exceeded one-third of their workday. The finding is a possible indicator that the EHR has room for usability, functionality improvement, and workflow optimization.

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The impact of an integrated electronic health record on nurse time at the bedside: A pre-post continuous time and motion study

Cited by 18 publications

References 47 publications

Barriers to Adoption of Electronic Health Record Systems from the Perspective of Nurses

Barriers to Adoption of Electronic Health Record Systems from the Perspective of Nurses

Effects of Electronic Health Record Implementation and Barriers to Adoption and Use: A Scoping Review and Qualitative Analysis of the Content

Interaction Time with Electronic Health Records: A Systematic Review

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