Electronic Health Record Implementations and Insufficient Training Endanger Nurses’ Well-being: Cross-sectional Survey Study
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 ind...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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JMIR Publications
2021-12-01
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| Series: | Journal of Medical Internet Research |
| Online Access: | https://www.jmir.org/2021/12/e27096 |
| _version_ | 1827858732086722560 |
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| author | Tarja Heponiemi Kia Gluschkoff Tuulikki Vehko Anu-Marja Kaihlanen Kaija Saranto Sari Nissinen Janna Nadav Sari Kujala |
| author_facet | Tarja Heponiemi Kia Gluschkoff Tuulikki Vehko Anu-Marja Kaihlanen Kaija Saranto Sari Nissinen Janna Nadav Sari Kujala |
| author_sort | Tarja Heponiemi |
| collection | DOAJ |
| description |
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 (F1=153.40, P<.001), time pressure (F1=80.95, P<.001), and cognitive failures (F1=34.96, P<.001) than those who had received insufficient training. Recent implementations and insufficient training were especially strongly associated with high levels of SRIS in hospitals.
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. |
| first_indexed | 2024-03-12T12:59:17Z |
| format | Article |
| id | doaj.art-3363ff520364432f8a65a885693eb5a3 |
| institution | Directory Open Access Journal |
| issn | 1438-8871 |
| language | English |
| last_indexed | 2024-03-12T12:59:17Z |
| publishDate | 2021-12-01 |
| publisher | JMIR Publications |
| record_format | Article |
| series | Journal of Medical Internet Research |
| spelling | doaj.art-3363ff520364432f8a65a885693eb5a32023-08-28T20:04:25ZengJMIR PublicationsJournal of Medical Internet Research1438-88712021-12-012312e2709610.2196/27096Electronic Health Record Implementations and Insufficient Training Endanger Nurses’ Well-being: Cross-sectional Survey StudyTarja Heponiemihttps://orcid.org/0000-0001-8540-049XKia Gluschkoffhttps://orcid.org/0000-0002-0340-4209Tuulikki Vehkohttps://orcid.org/0000-0002-0034-8379Anu-Marja Kaihlanenhttps://orcid.org/0000-0002-4033-3673Kaija Sarantohttps://orcid.org/0000-0002-3195-1955Sari Nissinenhttps://orcid.org/0000-0002-8696-434XJanna Nadavhttps://orcid.org/0000-0002-9735-3480Sari Kujalahttps://orcid.org/0000-0001-5586-3725 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 (F1=153.40, P<.001), time pressure (F1=80.95, P<.001), and cognitive failures (F1=34.96, P<.001) than those who had received insufficient training. Recent implementations and insufficient training were especially strongly associated with high levels of SRIS in hospitals. 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.https://www.jmir.org/2021/12/e27096 |
| spellingShingle | Tarja Heponiemi Kia Gluschkoff Tuulikki Vehko Anu-Marja Kaihlanen Kaija Saranto Sari Nissinen Janna Nadav Sari Kujala Electronic Health Record Implementations and Insufficient Training Endanger Nurses’ Well-being: Cross-sectional Survey Study Journal of Medical Internet Research |
| title | Electronic Health Record Implementations and Insufficient Training Endanger Nurses’ Well-being: Cross-sectional Survey Study |
| title_full | Electronic Health Record Implementations and Insufficient Training Endanger Nurses’ Well-being: Cross-sectional Survey Study |
| title_fullStr | Electronic Health Record Implementations and Insufficient Training Endanger Nurses’ Well-being: Cross-sectional Survey Study |
| title_full_unstemmed | Electronic Health Record Implementations and Insufficient Training Endanger Nurses’ Well-being: Cross-sectional Survey Study |
| title_short | Electronic Health Record Implementations and Insufficient Training Endanger Nurses’ Well-being: Cross-sectional Survey Study |
| title_sort | electronic health record implementations and insufficient training endanger nurses well being cross sectional survey study |
| url | https://www.jmir.org/2021/12/e27096 |
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