The electronic health record’s impact on nurses’ cognitive work: An integrative review

Wisner, Kirsten; Lyndon, Audrey; Chesla, Catherine A.

doi:10.1016/j.ijnurstu.2019.03.003

Cited by 81 publications

(98 citation statements)

References 29 publications

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“…Thus, the role of nurse staffing in increasing life expectancy varies between different health care systems of developed countries which is a logical result considering the effect of other determinant factors on life expectancy indicators, such as national income and aggregate HCE [[37], [38], [39], [40], [41]], better education, healthier lifestyles [2] and the progress in health care [1,3] and its accessibility [36]. According to the available health data at a cross-national level, the limitation of this study is the lack of other nursing competency indicators like working environment [42], job satisfaction [43] and use of technology [44] in our analysis.…”

Section: Discussionmentioning

confidence: 99%

Nurse staffing and life expectancy at birth and at 65 years old: Evidence from 35 OECD countries

Amiri

2019

International Journal of Nursing Sciences

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ObjectiveTo measure the possible magnitude of the role nurse staffing has on increasing life expectancy at birth and at 65 years old.MethodsThe statistical technique of panel data analysis was applied to investigate the relationship from the number of practicing nurses’ density per 1000 population to life expectancy at birth and at 65 years old. Five control variables were used as the proxies for the levels of medical staffing, health care financial and physical resources, and medical technology. The observations of 35 member countries of Organization for Economic Co-operation and Development (OECD) were collected from OECD Health Statistics over 2000–2016 period.ResultsThere were meaningful relationships from nurse staffing to life expectancy at birth and at 65 years with the long-run elasticities of 0.02 and 0.08, respectively. Overall, the role of nursing characteristics in increasing life expectancy indicators varied among different health care systems of OECD countries and in average were determined at the highest level in Japan (0.25), followed by Iceland (0.24), Belgium (0.21), Czech Republic (0.21), Slovenia (0.20) and Sweden (0.18).ConclusionA higher proportion of nursing staff is associated with higher life expectancy in OECD countries and the dependency of life expectancy to nursing staff would increase by aging. Hence, the findings of this study warn health policy makers about ignoring the effects nursing shortages create e.g. increasing the risk of actual age-specific mortality, especially in care of elderly people.

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Section: Discussionmentioning

confidence: 99%

Nurse staffing and life expectancy at birth and at 65 years old: Evidence from 35 OECD countries

Amiri

2019

International Journal of Nursing Sciences

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“…A recent review by Wisner et al concluded that EHRs have the potential to support the cognitive work of health care staff, but the scattering of information, information complexity, and lack of chronology often hampers this. Encountering problems while trying to find or synthesize information can affect a nurse's ability to achieve and maintain clinical understanding and situational awareness, which can compromise patient safety [8]. Usability and stability of information systems as well as end user involvement in system development and work procedure planning may be significant factors in alleviating stress related to information systems [15,26].…”

Section: Xsl • Fomentioning

confidence: 99%

“…In addition to the benefits identified (eg, reduction of medication errors), health care professionals have reported disadvantages, such as increased emotional strain and increased errors when trying to learn and adapt to new technologies and managing their workflow disruptions [2,5,6]. Implementation and use of EHRs have also required increased effort from professionals in performing their typical task flow [7], which in turn has resulted in increased cognitive workload and decreased cognitive performance [8]. In addition to missing focus on proactive workflow redesign during EHR implementation, earlier studies have found that many of the unfavorable consequences are connected with the usability issues of EHR systems, referring to how easy the system is to use and how precisely and efficiently required tasks can be performed [9,10].…”

Section: Introductionmentioning

confidence: 99%

The Associations of Electronic Health Record Usability and User Age With Stress and Cognitive Failures Among Finnish Registered Nurses: Cross-Sectional Study

Kaihlanen¹,

Gluschkoff²,

Hyppönen³

et al. 2020

JMIR Med Inform

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Background Electronic health records (EHRs) are expected to provide many clinical and organizational benefits. Simultaneously, the end users may face unintended consequences, such as stress and increased cognitive workload, due to poor EHR usability. However, whether the effects of usability depend on end user characteristics, such as career stage or age, remains poorly understood. Objective The objective of this study was to examine the associations of EHR usability and user age with stress related to information systems and cognitive failures among registered nurses. Methods A cross-sectional survey design was employed in Finland in 2017. A total of 3383 registered nurses responded to the nationwide electronic survey. Multiple linear regression was used to examine the associations of EHR usability (eg, how easily information can be found and a patient’s care can be documented) and user age with stress related to information systems and cognitive failures. Interaction effects of EHR usability and age were also tested. Models were adjusted for gender and employment sector. Results Poor EHR usability was associated with higher levels of stress related to information systems (β=.38; P<.001). The strength of the association did not depend on user age. Poor EHR usability was also associated with higher levels of cognitive failures (β=.28; P<.001). There was a significant interaction effect between age and EHR usability for cognitive failures (β=.04; P<.001). Young nurses who found the EHR difficult to use reported the most cognitive failures. Conclusions Information system stress due to poor EHR usability afflicts younger and older nurses alike. However, younger nurses starting their careers may be more cognitively burdened if they find EHR systems difficult to use compared to older nurses. Adequate support in using the EHRs may be particularly important to young registered nurses, who have a lot to learn and adopt in their early years of practice.

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“…These systems were used to store clinical notes and laboratory results in its multiple components [1]. They were proposed to enhance the safety aspect of the patients by preventing errors and increasing information access [2]. The goal of EHR systems was to solve the problems faced by the paper-based healthcare records and to provide an efficient system that would transform the state of healthcare sector [3].…”

Section: Introductionmentioning

confidence: 99%

Using Blockchain for Electronic Health Records

2019

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Blockchain have been an interesting research area for a long time and the benefits it provides have been used by a number of various industries. Similarly, the healthcare sector stands to benefit immensely from the blockchain technology due to security, privacy, confidentiality and decentralization. Nevertheless, the Electronic Health Record (EHR) systems face problems regarding data security, integrity and management. In this paper, we discuss how the blockchain technology can be used to transform the EHR systems and could be a solution of these issues. We present a framework that could be used for the implementation of blockchain technology in healthcare sector for EHR. The aim of our proposed framework is firstly to implement blockchain technology for EHR and secondly to provide secure storage of electronic records by defining granular access rules for the users of the proposed framework. Moreover, this framework also discusses the scalability problem faced by the blockchain technology in general via use of off-chain storage of the records. This framework provides the EHR system with the benefits of having a scalable, secure and integral blockchain-based solution.INDEX TERMS Blockchain, health records, electronic health records, decentralization, and scalability.

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The electronic health record’s impact on nurses’ cognitive work: An integrative review

Cited by 81 publications

References 29 publications

Nurse staffing and life expectancy at birth and at 65 years old: Evidence from 35 OECD countries

Nurse staffing and life expectancy at birth and at 65 years old: Evidence from 35 OECD countries

The Associations of Electronic Health Record Usability and User Age With Stress and Cognitive Failures Among Finnish Registered Nurses: Cross-Sectional Study

Using Blockchain for Electronic Health Records

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