ReviewJournal of the American Medical Informatics Association : JAMIA2020
Nurse workarounds in the electronic health record: An integrative review.
Review in Journal of the American Medical Informatics Association : JAMIA, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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
17 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Factors Influencing the Implementation and Adoption of Digital Nursing Technologies: Systematic Umbrella Review.Journal of medical Internet research · 2025Pooled it
- A Systematic Review of Quantitative Methods for Evaluating Electronic Medication Administration Record and Bar-Coded Medication Administration Usability.Applied clinical informatics · 2023Pooled it
- Examining Care Planning Efficiency and Clinical Decision Support Adoption in a System Tailoring to Nurses' Graph Literacy: National, Web-Based Randomized Controlled Trial.Journal of medical Internet research · 2023Trial
- "Most of what I do is a workaround now": Clinician Use of Workarounds Following an EHR Transition.Journal of general internal medicine · 2026Article
- The Impact of Digital Transformation on Nursing Professional Experience: Critical Interpretive Synthesis Review Developing the Fragmented Professional Transition in Nursing (FPT-N) Model.Asian/Pacific Island nursing journal · 2026Review
- The Impact of Electronic Health Records on Nurses and Nursing Care in Low- and Middle-Income Countries: A Scoping Review.Nursing open · 2026Article
- Do healthcare professionals work around safety standards, and should we be worried? A scoping review.BMJ quality & safety · 2025Article
- An Evaluation of the NANDA International, Inc., Diagnostic Classification Among Spanish Nurses: A Cross-Sectional Study.Nursing reports (Pavia, Italy) · 2025Article
- "I know I shouldn't but …" the inevitable tension of using workarounds to be a "good nurse".Frontiers in health services · 2025Article
- Effect of a closed-loop medication order executive system on safe medication administration at a tertiary hospital: a quasi-experimental study.Therapeutic advances in drug safety · 2024Article
- Domesticating Social Alarm Systems in Nursing Homes: Qualitative Study of Differences in the Perspectives of Assistant Nurses.Journal of medical Internet research · 2023Article
- Information and Data Visualization Needs among Direct Care Nurses in the Intensive Care Unit.Applied clinical informatics · 2022Article
- Nurses' Experiences After Implementation of an Organization-Wide Electronic Medical Record: Qualitative Descriptive Study.JMIR nursing · 2022Article
- Workarounds in Electronic Health Record Systems and the Revised Sociotechnical Electronic Health Record Workaround Analysis Framework: Scoping Review.Journal of medical Internet research · 2022Article
- Nursing documentation and its relationship with perceived nursing workload: a mixed-methods study among community nurses.BMC nursing · 2022Article
- Human Factors and Organizational Issues in Health Informatics: Innovations and Opportunities.Yearbook of medical informatics · 2021Review
- Primary Care Nurses' Experiences of Structured Documentation: A Qualitative Interview Study.Global qualitative nursing researchArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe study sought to synthesize published literature on direct care nurses' use of workarounds related to the electronic health record. MATERIALS AND
methodsWe conducted an integrative review of qualitative and quantitative peer-reviewed research through a structured search of Academic Search Complete, EBSCO Cumulative Index of Nursing and Allied Health Literature (CINAHL), Embase, Engineering Village, Ovid Medline, Scopus, and Web of Science. We systematically applied exclusion rules at the title, abstract, and full article stages and extracted and synthesized their research methods, workaround classifications, and probable causes from articles meeting inclusion criteria.
resultsOur search yielded 5221 results. After removing duplicates and applying rules, 33 results met inclusion criteria. A total of 22 articles used qualitative approaches, 10 used mixed methods, and 1 used quantitative methods. While researchers may classify workarounds differently, they generally fit 1 of 3 broad categories: omission of process steps, steps performed out of sequence, and unauthorized process steps. Each study identified probable causes, which included technology, task, organizational, patient, environmental, and usability factors.
conclusionsExtensive study of nurse workarounds in acute settings highlights the gap in ambulatory care research. Despite decades of electronic health record development, poor usability remains a key concern for nurses and other members of care team. The widespread use of workarounds by the largest group of healthcare providers subverts quality health care at every level of the healthcare system. Research is needed to explore the gaps in our understanding of and identify strategies to reduce workaround behaviors.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.