- Although EHR technology has improved patient safety and team-based healthcare, nurses still report negative opinions of the tools, according to a recent survey from the Adventist University of Health Sciences.
The survey questioned nurses about their opinions of EHR technology and how it has fit into their clinical workflows. Overwhelmingly, nurse respondents had negative views of EHRs, with 92 percent of them reporting dissatisfaction in 2014.
Eighty-four percent stated that EHRs disrupted their clinical workflows and productivity, while 85 percent said their tools consistently had flaws and glitches. Eighty-eight percent of respondents stated that high-ranking hospital officials were to blame for the glitches, alleging that they had invested in cheap technology.
The tools have also negatively affected their working relationships, the respondents noted. Ninety percent said EHRs got in the way of their patient-provider relationships, while ninety-four percent said they had not improved communication between themselves and doctors.
Nurse views on EHRs are not all bad, however. Seventy-one percent of nurse respondents said they would not go back to using paper records, showing that they do see some sort of value in the tool.
Much of that value, the survey reveals, surrounds patient safety improvements. Seventy-three percent of respondents said EHRs made it easier for them to communicate with providers outside of their institution, helping to boost care coordination. Seventy-two percent said their EHR helped prevent medication errors, likewise improving patient safety.
Statistically, hospitals with advanced EHR systems experienced a decline in patient safety issues. Twenty-seven percent saw a decrease in adverse safety events, 30 percent saw a decrease in medication errors, and 25 percent saw a decrease in events related to complications.
EHRs also helped patients with specific conditions, such as those with pneumonia or who had undergone cardiovascular surgery. Pneumonia patients at a hospital with an advanced EHR were 34 percent less likely to acquire an infection, while surgical patients saw 31 percent fewer post-procedural adverse events.
Going forward, the survey authors said the industry will need to work to alleviate some of the reported issues surrounding EHRs, such as those listed by the nurse respondents in this survey. The American Medical Informatics Association (AMIA), the authors said, is doing its part by stating five goals it aims to achieve by 2020.
These goals include simplifying and speeding documentation, refocusing regulation, increasing technology transparency and streamlining certification, fostering technology innovation, and supporting patient-centered care.
This survey stands in contrast to previous work that has explored the effect EHR technology has on nursing workflows. Earlier this year, researchers investigated the effectiveness of EHR technology on clinical workflows and care quality. The researchers also looked at how EHRs affected nursing satisfaction and employee turnover.
Overall, EHR adoption had a positive effect on nursing clinical workflows. Nearly all clinical quality measures improved, with fall rates reducing by 15 percent, and infections improving over the course of the study.
The researchers did see an increase in nursing staff turnover. Immediately after EHR implementation, nursing staff remained fairly consistent. However, turnover rates began to increase toward the end of the study.
The researchers hypothesized that turnover rates were the result of varying health IT competency levels and EHR sophistication.
Overall, this study showed that hospitals must take certain positive steps to effectively implement an EHR.
“To provide excellent patient care and maintain control over their work environment during the implementation of an EHR, a combination of changes must occur, including development of evidenced-based education with standards of care, monitoring of practice standards, redesign of nursing units for efficiency, and a modification of certain nursing activities,” the research team explained.
In the future, hospital and nursing leaders will need to acknowledge those workflow changes that will foster a better and more effective EHR implementation. As these technologies become staples in healthcare, it will be important that all members of the care team – including nurses – are competent and comfortable with the tools.