Difference between revisions of "Assessment of electronic health record usability with undergraduate nursing students"

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== Abstract ==
 
== Abstract ==
 
 
 
 
One of the health problems that is related to aging is heart failure.  Inadequate care of elderly patients with heart failure increases the chances of frequent hospital re-admissions and mortality rate (de Vries, van der Wal, Nieuwenhuis, de Jong, van Dijk, Jaarsma, Hillege, & Jorna, 2013, p. 1).  The authors believe that the use of clinical decision support systems (CDSS) may help cardiac nurses and cardiologists prevent frequent hospital re-admissions and decrease mortality rate in elderly patients with history of heart failureThe authors believe that cardiac nurses and cardiologists are not utilizing the CDSS because of perceived barriers associated with the implementation of CDSS in the treatment of heart failure patients and the lack of knowledge and management of CDSS.
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The authors of this article understand the importance of electronic health records (EHR) in the future of health careThey noticed that although EHRs were beginning to be implemented in many major hospitals, there existed few nursing schools that had a curriculum plan that taught about the fundamentals of EHRs.  
 
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==Methods==
 
==Methods==
  
The authors developed a questionnaire that “consists of 49 items, focusing on perceived barriers using a 5-point Likert type rating scale” (de Vries et al., 2013, p. 2)Because the authors were based in the Netherlands, the questionnaires were sent to heart failure clinics in the Netherlands.  The questionnaires were answered by 36 cardiologists and 126 cardiac nurses30% of the questionnaire responders had experience in working with CDSS because they used telemonitoring systems that had CDSS functions.
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The authors conducted a study to explore the usability of EHRs with undergraduate nursing students13 undergraduate nursing students were included in the study.  93% of the nursing students ranked themselves as being proficient or expert computer users.  The nursing students had completed four clinical placements in which they had interactions with patients in hospitals and used their documentation knowledge on paper charting to document their careNone of the nursing students had used EHRs in documenting patient care; however, they stated that they were aware of EHR.  
  
 
== Results ==
 
== Results ==
  
The authors were able to conclude that for cardiologists, factors such as age, gender, and experience with computers were not a barrier in the implementation of CDSSHowever, for cardiac nurses, experiences with computers were a strong barrier in the implementation of CDSS.  The authors suggested that clinicians increase their training of the functions of CDSS in order to gain more experience with CDSSThis will lead the clinicians to develop stronger knowledge and management skills of the functions of CDSSWith more experience with the CDSS, there will be fewer barriers with CDSS.
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The study was able to establish three EHR usability themes:  novice users, confidentiality and security, and repetition and practice.  The study showed that as nursing students with no experience in EHR, they did not know where to document their patient care and where to search for the patient’s history.  This led to time being spent on locating the correct areas in the EHRConfidentiality and security occurred when the nursing students forgot to close browser windows that were left open after the nursing students logged off from the EHR program.  The nursing students stated that repetition and practice with EHR would greatly enhance their ability to navigate through the EHR programThe authors discovered that although the nursing students were considered to be in the “computer age” generation, they had challenges with the use of EHRThe authors propose that curriculums about the EHR system should be offered during the nursing education to enhance all nursing students’ familiarity with navigating EHRs.  
  
  

Revision as of 02:29, 4 March 2015

The following is a review of the article, “Assessment of electronic health record usability with undergraduate nursing students " [1].


Abstract

The authors of this article understand the importance of electronic health records (EHR) in the future of health care. They noticed that although EHRs were beginning to be implemented in many major hospitals, there existed few nursing schools that had a curriculum plan that taught about the fundamentals of EHRs.

Methods

The authors conducted a study to explore the usability of EHRs with undergraduate nursing students. 13 undergraduate nursing students were included in the study. 93% of the nursing students ranked themselves as being proficient or expert computer users. The nursing students had completed four clinical placements in which they had interactions with patients in hospitals and used their documentation knowledge on paper charting to document their care. None of the nursing students had used EHRs in documenting patient care; however, they stated that they were aware of EHR.

Results

The study was able to establish three EHR usability themes: novice users, confidentiality and security, and repetition and practice. The study showed that as nursing students with no experience in EHR, they did not know where to document their patient care and where to search for the patient’s history. This led to time being spent on locating the correct areas in the EHR. Confidentiality and security occurred when the nursing students forgot to close browser windows that were left open after the nursing students logged off from the EHR program. The nursing students stated that repetition and practice with EHR would greatly enhance their ability to navigate through the EHR program. The authors discovered that although the nursing students were considered to be in the “computer age” generation, they had challenges with the use of EHR. The authors propose that curriculums about the EHR system should be offered during the nursing education to enhance all nursing students’ familiarity with navigating EHRs.


Comments

This article serves as a good guidance in teaching the importance of training staffers well when implementing CDSS. CDSS can be a powerful tool, however, when there are barriers against it, it becomes limited in its potential. Continual training on the functions of CDSS is one way to make the user experience more effective.

References

  1. Jones, S. & Donelle, L. (2011). Assessment of electronic health record usability with undergraduate nursing students. International Journal of Nursing Education Scholarship, 8(1), 1-18.