This study addresses community hospital nurses' use of electronic health records and views of the impact of such records on job performance and patient outcomes. Questionnaire, interview, and observation data from 46 nurses in medical-surgical and intensive care units at two community hospitals were analyzed. Nurses preferred electronic health records to paper charts and were comfortable with technology. They reported use of electronic health records enhanced nursing work through increased information access, improved organization and efficiency, and helpful alert screens. They thought use of the records hindered nursing work through impaired critical thinking, decreased interdisciplinary communication, and a high demand on work time (73% reported spending at least half their shift using the records). They thought use of electronic health records enabled them to provide safer care but decreased the quality of care. Administrative implications include involving bedside nurses in system choice, streamlining processes, developing guidelines for consistent documentation quality and location, increasing system speed, choosing hardware that encourages bedside use, and improving system information technology support.
Author Affiliations: University of Wisconsin-Madison and Illinois State University, Mennonite College of Nursing, Normal, IL (Dr Kossman); and OSF St. Joseph Medical Center, Bloomington, IL (Ms Scheidenhelm).
Financial Disclosure: Dr Kossman is supported by a National Library of Medicine Postdoctoral Fellowship (1F37 LM009063-01).
Funding/Support: The study was supported by a grant from Xi Pi Chapter, Sigma Theta Tau, International.
Previous Presentation: Preliminary findings of this research were presented at the Summer Institute for Nursing Informatics, Baltimore, MD, July 20-23, 2005 and Midwest Nursing Research Society Annual Conference, Milwaukee, WI, March 31-April 3, 2006 conferences and the 9th International Congress on Nursing Informatics Seoul, South Korea, June 11-14, 2006 (NI2006).
Corresponding author: Susan P. Kossman, RN, PhD, Campus Box 5810, Illinois State University, Normal, IL 61790-5810 (firstname.lastname@example.org).