ArticleApplied clinical informatics2019
Electronic Health Record Adoption and Nurse Reports of Usability and Quality of Care: The Role of Work Environment.
Article in Applied clinical informatics, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 2 of them syntheses that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
27 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The Impact of Digital Hospitals on Patient and Clinician Experience: Systematic Review and Qualitative Evidence Synthesis.Journal of medical Internet research · 2024Pooled it
- Adoption of electronic health record systems to enhance the quality of healthcare in low-income countries: a systematic review.BMJ health & care informatics · 2023Pooled it
- Predicting Electronic Health Record Usability: Scoping Review of Adoption Models, Metrics, and Future Directions.JMIR human factors · 2026Article
- Hospital Digital Transformation, Nursing Data Burden, and Leadership and Governance Capacity: A Critical Narrative Review.Journal of nursing management · 2026Review
- Authentic Leadership of Nurses in the Hospital: A Scoping Review.Healthcare (Basel, Switzerland) · 2025Review
- The impact of inpatient medication administration technologies on nursing autonomy and practice: a meta-ethnographic synthesis of the qualitative literature.Journal of the American Medical Informatics Association : JAMIA · 2025Article
- Information Prioritization and Reading Patterns in Electronic Health Record Nursing Summaries: An Eye-Tracking Case Study.Applied clinical informatics · 2025Article
- Usability of an electronic health record 6 months post go-live and its association with burnout, insomnia and turnover intention: a cross-sectional study in a hospital setting.BMJ health & care informatics · 2025Article
- Applicability of electronic health records in the hospital Nursing Process: a scoping review.Revista brasileira de enfermagem · 2025Article
- Nurses' Satisfaction with Adopting a Homegrown Public Tertiary Hospital Electronic Medical Record during the Pandemic.Acta medica Philippina · 2025Article
- Impact of Implementing Electronic Nursing Records on Quality and Safety Indicators in Care.The Libyan journal of medicine · 2024Article
- Examining nurses' awareness level and compliance between defined and required access levels to core functionalities of hospital information system : an observational and survey study.BMC health services research · 2024Observational
- Perceptions of hospital electronic health record (EHR) training, support, and patient safety by staff position and tenure.BMC health services research · 2024Article
- Adoption of Electronic Health Record Among Substance Use Disorder Treatment Programs: Nationwide Cross-Sectional Survey Study.Journal of medical Internet research · 2023Article
- Workflow Improvement of Electronic Health Record Usage in a Tertiary Pediatric Burns Clinic.Applied clinical informatics · 2023Observational
- Nursing staff's assessments of medication management process in the psychiatric and operative domains: A cross-sectional study after introduction of an electronic medication chart.Scandinavian journal of caring sciences · 2022Article
- Nurses' Experiences After Implementation of an Organization-Wide Electronic Medical Record: Qualitative Descriptive Study.JMIR nursing · 2022Article
- Single-Vendor Electronic Health Record Use Is Associated With Greater Opportunities for Organizational and Clinical Care Improvements.Mayo Clinic proceedings. Innovations, quality & outcomes · 2022Article
- The Impact of COVID-19 on Levels of Adherence to the Completion of Nursing Records for Inpatients in Isolation.International journal of environmental research and public health · 2021Observational
- Beyond Getting Rid of Stupid Stuff in the Electronic Health Record (Beyond-GROSS): Protocol for a User-Centered, Mixed-Method Intervention to Improve the Electronic Health Record System.JMIR research protocols · 2021Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
backgroundDespite evidence suggesting higher quality and safer care in hospitals with comprehensive electronic health record (EHR) systems, factors related to advanced system usability remain largely unknown, particularly among nurses. Little empirical research has examined sociotechnical factors, such as the work environment, that may shape the relationship between advanced EHR adoption and quality of care.
objectiveThe objective of this study was to examine the independent and joint effects of comprehensive EHR adoption and the hospital work environment on nurse reports of EHR usability and nurse-reported quality of care and safety.
methodsThis study was a secondary analysis of nurse and hospital survey data. Unadjusted and adjusted logistic regression models were used to assess the relationship between EHR adoption level, work environment, and a set of EHR usability and quality/safety outcomes. The sample included 12,377 nurses working in 353 hospitals.
resultsIn fully adjusted models, comprehensive EHR adoption was associated with lower odds of nurses reporting poor usability outcomes, such as dissatisfaction with the system (odds ratio [OR]: 0.75; 95% confidence interval [CI]: 0.61-0.92). The work environment was associated with all usability outcomes with nurses in better environments being less likely to report negatively. Comprehensive EHRs (OR: 0.83; 95% CI: 0.71-0.96) and better work environments (OR: 0.47; 95% CI: 0.42-0.52) were associated with lower odds of nurses reporting fair/poor quality of care, while poor patient safety grade was associated with the work environment (OR: 0.50; 95% CI: 0.46-0.54), but not EHR adoption level.
conclusionOur findings suggest that adoption of a comprehensive EHR is associated with more positive usability ratings and higher quality of care. We also found that-independent of EHR adoption level-the hospital work environment plays a significant role in how nurses evaluate EHR usability and whether EHRs have their intended effects on improving quality and safety of care.
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Registered trials
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