ArticleJournal of medical Internet research2021
Electronic Health Record Implementations and Insufficient Training Endanger Nurses' Well-being: Cross-sectional Survey Study.
Article in Journal of medical Internet research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it, 45 citations in OpenAlex.
- The Impact of Digital Hospitals on Patient and Clinician Experience: Systematic Review and Qualitative Evidence Synthesis.Journal of medical Internet research · 2024Pooled it
- Physicians' Perceptions of Information Quality and Access in a New Cross-Institutional Electronic Health Record (EHR) System: Mixed Methods Design.JMIR formative research · 2026Article
- Digital-Use/Efficiency Phenotypes Versus Professional Role in Explaining Perceived Digital Benefit in Anaesthesia and Intensive Care.Healthcare (Basel, Switzerland) · 2026Article
- Artificial Intelligence Literacy and Subjective Workload Among Clinical Nurses: A Cross-Sectional Study.Healthcare (Basel, Switzerland) · 2026Article
- Electronic health records in patient care: strengths, facilitators, challenges, and future directions-a scoping review.BMC health services research · 2026Article
- The Impact of Electronic Health Records on Nurses and Nursing Care in Low- and Middle-Income Countries: A Scoping Review.Nursing open · 2026Article
- "The emperor's new clothes": a qualitative study of end users' experiences from a failed large-scale implementation of an electronic health record system.BMC health services research · 2026Article
- Attitudes towards electronic health records and attending training among licensed practical nurses: a cross-sectional survey study.BMC nursing · 2026Article
- Hospital Digital Transformation, Nursing Data Burden, and Leadership and Governance Capacity: A Critical Narrative Review.Journal of nursing management · 2026Review
- Self-Reported Dyslexia Traits as Positive Predictors of Self-Reported Cognitive Failures in the Workplace.Behavioral sciences (Basel, Switzerland) · 2025Article
- Insights into healthcare workers' perceptions of electronic medical record system utilization: a cross-sectional study in Mafeteng district, Lesotho.BMC medical informatics and decision making · 2025Article
- Exploring Physicians' Dual Perspectives on the Transition From Free Text to Structured and Standardized Documentation Practices: Interview and Participant Observational Study.JMIR formative research · 2025Observational
- 25 Years of Electronic Health Record Implementation Processes: Scoping Review.Journal of medical Internet research · 2025Article
- Effect of a Practice-Oriented Electronic Medical Record Education Program for New Nurses.Healthcare (Basel, Switzerland) · 2025Article
- Measuring Managerial, Collegial, and Organizational Aspects Associated With Digital Health Competence in Healthcare Professionals: Validation of the Chinese Version of the DigiComInf Instrument.Journal of nursing management · 2025Article
- Factors Contributing to Successful Information System Implementation and Employee Well-Being in Health Care and Social Welfare Professionals: Comparative Cross-Sectional Study.JMIR medical informatics · 2024Article
- Implementation and delivery of electronic health records training programs for nurses working in inpatient settings: a scoping review.Journal of the American Medical Informatics Association : JAMIA · 2024Article
- Intensity of nursing work in a primary healthcare center: An observational study.International journal of nursing sciences · 2024Article
- Evaluating the Prevalence of Burnout Among Health Care Professionals Related to Electronic Health Record Use: Systematic Review and Meta-Analysis.JMIR medical informatics · 2024Review
- Clinician and staff experiences with frustrated patients during an electronic health record transition: a qualitative case study.BMC health services research · 2024Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHigh expectations have been set for the implementations of health information systems (HIS) in health care. However, nurses have been dissatisfied after implementations of HIS. In particular, poorly functioning electronic health records (EHRs) have been found to induce stress and cognitive workload. Moreover, the need to learn new systems may require considerable effort from nurses. Thus, EHR implementations may have an effect on the well-being of nurses.
objectiveThis study aimed to examine the associations of EHR-to-EHR implementations and the sufficiency of related training with perceived stress related to information systems (SRIS), time pressure, and cognitive failures among registered nurses. Moreover, we examined the moderating effect of the employment sector (hospital, primary care, social services, and others) on these associations.
methodsThis study was a cross-sectional survey study of 3610 registered Finnish nurses in 2020. EHR implementation was measured by assessing whether the work unit of each respondent had implemented or will implement a new EHR (1) within the last 6 months, (2) within the last 12 months, (3) in the next 12 months, and (4) at no point within the last 12 months or in the forthcoming 12 months. The associations were examined using analyses of covariance adjusted for age, gender, and employment sector.
resultsThe highest levels of SRIS (adjusted mean 4.07, SE 0.05) and time pressure (adjusted mean 4.55, SE 0.06) were observed among those who had experienced an EHR implementation within the last 6 months. The lowest levels of SRIS (adjusted mean 3.26, SE 0.04), time pressure (adjusted mean 4.41, SE 0.05), and cognitive failures (adjusted mean 1.84, SE 0.02) were observed among those who did not experience any completed or forthcoming implementations within 12 months. Nurses who perceived that they had received sufficient implementation-related training experienced less SRIS (F
conclusionsEHR implementations and insufficient training related to these implementations may endanger the well-being of nurses and even lead to errors. Thus, it is extremely important for organizations to offer comprehensive training before, during, and after implementations. Moreover, easy-to-use systems that allow transition periods, a re-engineering approach, and user involvement may be beneficial to nurses in the implementation process. Training and other improvements would be especially important in hospitals.
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