ICU nurses' acceptance of electronic health records
- Pascale Carayon1,2,
- Randi Cartmill2,
- Mary Ann Blosky3,
- Roger Brown4,5,
- Matthew Hackenberg3,
- Peter Hoonakker2,
- Ann Schoofs Hundt2,
- Evan Norfolk3,
- Tosha B Wetterneck2,4,
- James M Walker3
- 1Department of Industrial and Systems Engineering, University of Wisconsin-Madison, Madison, Wisconsin, USA
- 2Center for Quality and Productivity Improvement, University of Wisconsin-Madison, Madison, Wisconsin, USA
- 3Geisinger Health System, Danville, Pennsylvania, USA
- 4School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
- 5School of Nursing, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Correspondence to Pascale Carayon, Department of Industrial and Systems Engineering, Center for Quality and Productivity Improvement, University of Wisconsin-Madison, 1550 Engineering Drive, 3126 Engineering Centers Building, Madison, WI 53706-1609, USA; carayon{at}engr.wisc.edu
- Received 11 October 2010
- Accepted 20 April 2011
- Published Online First 22 June 2011
Abstract
Objective To assess intensive care unit (ICU) nurses' acceptance of electronic health records (EHR) technology and examine the relationship between EHR design, implementation factors, and nurse acceptance.
Design The authors analyzed data from two cross-sectional survey questionnaires distributed to nurses working in four ICUs at a northeastern US regional medical center, 3 months and 12 months after EHR implementation.
Measurements Survey items were drawn from established instruments used to measure EHR acceptance and usability, and the usefulness of three EHR functionalities, specifically computerized provider order entry (CPOE), the electronic medication administration record (eMAR), and a nursing documentation flowsheet.
Results On average, ICU nurses were more accepting of the EHR at 12 months as compared to 3 months. They also perceived the EHR as being more usable and both CPOE and eMAR as being more useful. Multivariate hierarchical modeling indicated that EHR usability and CPOE usefulness predicted EHR acceptance at both 3 and 12 months. At 3 months postimplementation, eMAR usefulness predicted EHR acceptance, but its effect disappeared at 12 months. Nursing flowsheet usefulness predicted EHR acceptance but only at 12 months.
Conclusion As the push toward implementation of EHR technology continues, more hospitals will face issues related to acceptance of EHR technology by staff caring for critically ill patients. This research suggests that factors related to technology design have strong effects on acceptance, even 1 year following the EHR implementation.
Footnotes
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Funding This research was made possible by grant R01 HS15274 from the Agency for Healthcare Research and Quality (PI: P Carayon). This publication was also supported by grant 1UL1RR025011 from the Clinical & Translational Science Award (CTSA) program of the National Center for Research Resources in the National Institutes of Health (PI: M Drezner).
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Competing interests None.
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Ethics approval Ethics approval was provided by the UW-Madison Health Sciences IRB.
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Provenance and peer review Not commissioned; externally peer reviewed.
