Evidence map›Paper›PMID 35881417›Full record

ArticleJMIR nursing2022

Nurses' Experiences After Implementation of an Organization-Wide Electronic Medical Record: Qualitative Descriptive Study.

Rebecca M Jedwab, Elizabeth Manias, Alison M Hutchinson, Naomi Dobroff, Bernice Redley

Abstract read
In one paragraph

Article in JMIR nursing, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Rebecca M JedwabCentre for Quality and Patient Safety Research-Monash Health Partnership, Institute for Health Transformation, School of Nursing and Midwifery, Deakin University, Melbourne, Australia.ORCID https://orcid.org/0000-0003-3014-8797
Elizabeth ManiasInstitute for Health Transformation, School of Nursing and Midwifery, Deakin University, Melbourne, Australia.ORCID https://orcid.org/0000-0002-3747-0087
Alison M HutchinsonCentre for Quality and Patient Safety Research-Monash Health Partnership, Institute for Health Transformation, School of Nursing and Midwifery, Deakin University, Melbourne, Australia.ORCID https://orcid.org/0000-0001-5065-2726
Naomi DobroffNursing and Midwifery Informatics, Monash Health, Melbourne, Australia.ORCID https://orcid.org/0000-0002-2373-4969
Bernice RedleyCentre for Quality and Patient Safety Research-Monash Health Partnership, Institute for Health Transformation, School of Nursing and Midwifery, Deakin University, Melbourne, Australia.ORCID https://orcid.org/0000-0002-2376-3989

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundReports on the impact of electronic medical record (EMR) systems on clinicians are mixed. Currently, nurses' experiences of adopting a large-scale, multisite EMR system have not been investigated. Nurses are the largest health care workforce; therefore, the impact of EMR implementation must be investigated and understood to ensure that patient care quality, changes to nurses' work, and nurses themselves are not negatively impacted.

objectiveThis study aims to explore Australian nurses' postimplementation experiences of an organization-wide EMR system.

methodsThis qualitative descriptive study used focus group and individual interviews and an open-ended survey question to collect data between 12 and 18 months after the implementation of an EMR across 6 hospital sites of a large health care organization in Victoria, Australia. Data were collected between November 2020 and June 2021, coinciding with the COVID-19 pandemic. Analysis comprised complementary inductive and deductive approaches. Specifically, reflexive thematic analysis was followed by framework analysis by the coding of data as barriers or facilitators to nurses' use of the EMR using the Theoretical Domains Framework.

resultsA total of 158 nurses participated in this study. The EMR implementation dramatically changed nurses' work and how they viewed their profession, and nurses were still adapting to the EMR implementation 18 months after implementation. Reflexive thematic analysis led to the development of 2 themes: An unintentional divide captured nurses' feelings of division related to how using the EMR affected nurses, patient care, and the broader nursing profession. This time, it's personal detailed nurses' beliefs about the EMR implementation leading to bigger changes to nurses as individuals and nursing as a profession than other changes that nurses have experienced within the health care organization. The most frequent barriers to EMR use by nurses were related to the Theoretical Domains Framework domain of environmental context and resources. Facilitators of EMR use were most often related to memory, attention, and decision processes. Most barriers and facilitators were related to motivation.

conclusionsNurses perceived EMR implementation to have a mixed impact on the provision of quality patient care and on their colleagues. Implementing technology in a health care setting was perceived as a complex endeavor that impacted nurses' perceptions of their autonomy, ways of working, and professional roles. Potential negative consequences were related to nursing workforce retention and patient care delivery. Motivation was the main behavioral driver for nurses' adoption of EMR systems and hence a key consideration for implementing interventions or organizational changes directed at nurses.

Indexed as

computerized medical records systemsCOVID-19implementation sciencemotivationnursesqualitative research

Identifiers

PMID35881417
PMCPMC9328123

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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.