Nursing Survey on Electronic Health Records System

Introduction

A wide variety of nursing research tools such as surveys, can be used in order to gather information on the views and opinions of a specific group of people on a particular clinical or organizational issue. This data is contributed to the nursing knowledge base, which can be used to evaluate and introduce changes based on these results. The current report will develop a survey tool for the nursing workforce in an organization using an electronic health records system.

Use of Surveys

A survey is defined as a systematic collection and analysis of data. A survey is most commonly considered to collect qualitative data, attempting to collect information on the characteristics, opinions, and attitudes of a population. Rather than focusing solely on factual matters, surveys are necessary to understand and predict behavior patterns. A survey should be designed with all intensive purposes to represent the content from a literature review accurately and can address specific researcher needs (Timmins, 2015). This survey will be designed based on the available research about the use of electronic health records by the nursing workforce with the purpose of deriving options for enhancing and optimizing the system.

Literature Review

Electronic health records (EHR) are an information system that has the primary function of patient data collection and storage adopted within healthcare systems. It is a “repository of information regarding the health status of a subject of care in computer processable form” (Nguyen, Bellucci, & Nguyen, 2014, p. 781). It is a record of every health-related event of a patient in the hospital. Although EHR can exist in a variety of different frameworks and functions, its fundamental concept inherently changes the organizational contexts of any hospital that implements this system. The American Recovery and Reinvestment Act of 2009 maintains a section on information technology that encourages healthcare providers to adopt EHR or risk punitive Medicare reimbursement penalties. Such a massive organizational change creates a myriad of issues for healthcare providers, including end-user adoption resistance. Workplace culture and needs, as well as employee preparation and training with the system, are some factors influencing EHR implementation and use (Barrett, 2017).

Nurses at all organizational levels are engaged with health information technology, including its design, selection, testing, and implementation. As a frontline staff, nurses are the most common users of HER, spending as much as 19% of work time documenting patient data. Research shows that there is a significant spread of confidence and competency with the system. Many nurses struggle to maintain a well-balanced level of confidence and competence with the tasks of electronic documentation (Mitchell, 2015). Since EHR is a necessary development in the modern healthcare system, its successful implementation depends on the vital role of nurses. However, overall readiness and understanding of the system remain low at 57.2%, with many citing the complexity of service delivery and lack of communication as adverse factors (Habibi-Koolaee, Safdari, & Hamid Bouraghi, 2015).

Demographics

Demographic data is a routine part of research since it allows us to derive characteristics of the sample population and organization. These statistics can be used to categorize the answers of a subset population and to help recognize patterns. Since the survey is focused on the nursing population, it should attempt to collect information relevant to the person’s job position and experience.

What is your age group?
  • 20-29yrs
  • 30-39yrs
  • 40-49yrs
  • 50-59yrs
  • 60-69yrs
  • 70yrs and over
What is your sex?
  • Male
  • Female
Indicate current job title or position: Indicate current nursing classification:
Number of years as a registered nurse: ___
Number of years in the current job position: ___
Indicate all levels of education received relevant to nursing/healthcare:
Have you received basic training for the use of EHR?
  • Yes
  • No
Indicate current practice setting and department:

Current Use

It is necessary to evaluate the current usage of the EHR system to determine the extent of its implementation and rate of acceptance.

Current Use of EHR Strongly
Agree
Agree Neutral Disagree Strongly
Disagree
Rating: 1 2 3 4 5
Do you use EHR on a daily basis?
Is the system easy to use?
Do you receive training and technical support on HER?
Is the software logical and easy to navigate in finding useful information?
The processing speed of EHR is fast.
Is the system easier to use than paper records?
I know which commands and prompts to use.
The EHR system commonly freezes or malfunctions.
The collection of patient data is helpful with EHR structure and reminders.
EHR displays relevant data on the screen.
Patient data collection or presentation is adequate in the level of detail.
EHR provides the necessary information to provide high-quality care to the patient.

Feedback and Satisfaction

An extensive international survey has shown that nurses’ satisfaction with electronic health records was low as participants indicated a wide range of concerns for the system and its functionality in clinical practice. A majority of issues were at the system level and user-task capabilities. There is significant advocacy for improved modifications and integration of the EHR from a nursing perspective (Topaz et al., 2016). The following survey questions will help to gauge nurses’ satisfaction and feedback about EHR usage in the organization.

Current Use of EHR Strongly
Agree
Agree Neutral Disagree Strongly
Disagree
Rating: 1 2 3 4 5
How satisfied are you with the current EHR system adopted by the organization?
How efficient is the system’s integration?
Are you satisfied with the system usability?
Do you believe that the EHR system is friendly or useful for nurses?
Do you think the system meets clinical nursing needs?
Are there organizational standards in place for the use of EHR?
Do you believe EHR is a limited concept?
Does the organization provide an adequate amount and quality of training?
Is EHR compatible with your current organization and clinical practice?
Is EHR compatible with other health technology or information systems used by the organization?
Do you feel forced to use EHR?
Would you use manual systems instead of EHR?
Does EHR improve the quality of care?

Improvement

The computerization of patient data using electronic health records has presented many effective measures and solutions to previous methods of recordkeeping. It has increased the availability and completeness of patient information. However, there are many aspects of the systems which require improvement to become effective tools in clinical care (Cimino, 2013). As EHR evolves, it is necessary to modify the system based on provided feedback for enhancement.

Current Use of EHR Strongly
Agree
Agree Neutral Disagree Strongly
Disagree
Rating: 1 2 3 4 5
Do you believe EHR functionality should be improved?
Does the HER system ask to collect or display irrelevant data?
Should the EHR user interface be improved?
Does EHR need interoperability improvements with other health information or basic electronic hardware?
Should the EHR interface be more dynamic and intuitive?
Does EHR need increased speed and connectivity?
Is there a need for better EHR integration into the clinical workflow?
Should EHR provide broader access to medical literature?
Should EHR include logistical aspects such as prescription management or appointment scheduling?
What other recommendations would you have for the enhancement of EHR use in the organization?

References

Barrett, A. K. (2017). Electronic health record (EHR) organizational change: Explaining resistance through profession, organizational experience, and EHR communication quality. Health Communication, 33(4), 496-506. Web.

Cimino, J. J. (2013). Improving the Electronic Health Record: Getting What We Wished For. JAMA : The Journal of the American Medical Association, 309(10), 10.1001/jama.2013.890. Web.

Habibi-Koolaee, M., Safdari, R., & Bouraghi, H. (2015). Nurses readiness and electronic health records. Acta Informatica Medica, 23(2), 105–107. Web.

Mitchell, J. (2015). Electronic documentation: assessment of newly graduated nurses’ competency and confidence levels. Online Journal of Nursing Informatics, 19(2), 1-7. Web.

Nguyen, L., Bellucci, E., & Nguyen, L. T. (2014). Electronic health records implementation: An evaluation of information system impact and contingency factors. International Journal of Medical Informatics, 83(11), 779-796. Web.

Timmins, F. (2015). Surveys and questionnaires in nursing research. Nursing Standard, 29(42), 42-50. Web.

Topaz, M., Ronquillo, C., Peltonen, L.-M., Pruinelli, L., Sarmiento, R. F., Badger, M. K., … Lee, Y.-L. (2016). Nurse informaticians report low satisfaction and multi-level concerns with electronic health records: Results from an international survey. AMIA Annual Symposium Proceedings, 2016–2025. Web.