The Nurses’ Mental Burden in Utilizing Electronic Medical Records in Hospitals
Abstract
Electronic Medical Record (EMR) revolutionize patient information management in healthcare but pose challenges for nurses, who play a crucial role in their utilization. Despite perceived benefits, nurses face significant mental burdens navigating these systems, requiring tailored strategies for successful integration. This article explores nurses' challenges with EMRs and proposes solutions to alleviate their burden while ensuring efficient patient care. This study employed a systematic literature review following the PRISMA method. Conducting searches across databases Scopus and PubMed using keywords “electronic medical record” and “nurse”. Total of 22 selected articles show that Nurses' cognitive challenges with EMRs in hospitals stem from design complexities, impacting workflow and decision-making, exacerbated by factors like experience levels and external events like the COVID-19 pandemic, while usability, system quality, and participatory design approaches can mitigate stressors and enhance nurses' engagement and efficiency. Nurses' EMR experiences impact their well-being and patient care. Addressing these challenges requires optimizing design, usability, training, and support. Supporting nurses in EMR use enhances patient care and well-being, necessitating ongoing research and collaboration for improvement.
References
Alshehri, A. A., & Alanazi, A. (2023). Usability study of an electronic medical record from the nurse practitioners’ practice: a qualitative study using the think-aloud technique. Cureus, 15(7). https://doi.org/10.7759/cureus.41603
Bechdel, B. A., Bardman, K. J., & Machemer, C. (2022). Developing a nurse-driven vascular access device order set using the electronic medical record. Journal of Infusion Nursing, 45(1), 20–26. https://doi.org/10.1097/nan.0000000000000450
Califf, C. B. (2022). Stressing affordances: Towards an appraisal theory of technostress through a case study of hospital nurses’ use of electronic medical record systems. Information and Organization, 32(4), 100431. https://doi.org/10.1016/j.infoandorg.2022.100431
Ghosh, K., Dohan, M. S., Curl, E., Goodwin, M., Morrell, P., & Guidroz, P. (2022). Information tools for care coordination in patient handover: Is an electronic medical record enough to support nurses? Health Care Management Review, 47(2), 100–108. https://doi.org/10.1097/hmr.0000000000000296
Guo, W., Kim, J. H., Smith, B., & Despins, L. (2019). How nurse experience influences the patterns of electronic medical record documentation in an intensive care unit. In Proceedings of the Human Factors and Ergonomics Society Annual Meeting (Vol. 63, pp. 708–712). SAGE Publications Sage CA: Los Angeles, CA. http://dx.doi.org/10.1177/1071181319631052
Jaber, M. J., Al-Bashaireh, A. M., Alqudah, O. M., Khraisat, O. M., Hamdan, K. M., AlTmaizy, H. M., … Allari, R. S. (2021). Nurses’ views on the use, quality, and satisfaction with electronic medical record in the outpatient department at a tertiary hospital. The Open Nursing Journal, 15(1). http://dx.doi.org/10.2174/1874434602115010254
Jedwab, R. M., Hutchinson, A. M., Manias, E., Calvo, R. A., Dobroff, N., Glozier, N., & Redley, B. (2021). Nurse motivation, engagement and well-being before an electronic medical record system implementation: a mixed methods study. International Journal of Environmental Research and Public Health, 18(5), 2726. https://doi.org/10.3390/ijerph18052726
Jedwab, R. M., Hutchinson, A. M., Manias, E., Calvo, R. A., Dobroff, N., & Redley, B. (2022). Change in nurses’ psychosocial characteristics pre-and post-electronic medical record system implementation coinciding with the SARS-CoV-2 pandemic: pre-and post-cross-sectional surveys. International Journal of Medical Informatics, 163, 104783. https://doi.org/10.1016/j.ijmedinf.2022.104783
Jedwab, R. M., Redley, B., Manias, E., Dobroff, N., & Hutchinson, A. M. (2021). How does implementation of an electronic medical record system impact nurses’ work motivation, engagement, satisfaction and well-being? A realist review protocol. BMJ Open, 11(10), e055847. https://doi.org/10.1136/bmjopen-2021-055847
Jimma, B. L., & Enyew, D. B. (2022). Barriers to the acceptance of electronic medical records from the perspective of physicians and nurses: A scoping review. Informatics in Medicine Unlocked, 31, 100991. http://dx.doi.org/10.1016/j.imu.2022.100991
Kernebeck, S., Busse, T. S., Jux, C., Dreier, L. A., Meyer, D., Zenz, D., … Ehlers, J. P. (2022). Evaluation of an electronic medical record module for nursing documentation in Paediatric palliative care: Involvement of nurses with a think-aloud approach. International Journal of Environmental Research and Public Health, 19(6), 3637. https://doi.org/10.3390/ijerph19063637
Kernebeck, S., Busse, T. S., Jux, C., Meyer, D., Dreier, L. A., Zenz, D., … Ehlers, J. P. (2021). Participatory design of an electronic medical record for paediatric palliative care: a think-aloud study with nurses and physicians. Children, 8(8), 695. https://doi.org/10.3390/children8080695
Kernebeck, S., Jux, C., Busse, T. S., Meyer, D., Dreier, L. A., Zenz, D., … Ehlers, J. P. (2022). Participatory Design of a Medication Module in an Electronic Medical Record for Paediatric Palliative Care: A Think-Aloud Approach with Nurses and Physicians. Children, 9(1), 82. https://doi.org/10.3390/children9010082
Kweon, Y.-R., & Lee, S. (2021). Nurses’ electronic medical record workarounds in mental healthcare settings. CIN: Computers, Informatics, Nursing, 39(10), 592–603. https://doi.org/10.1097/cin.0000000000000762
Larson, L. (2021). The Role of a Nurse Practitioner in a “Big Bang” Electronic Medical Record Implementation. CIN: Computers, Informatics, Nursing, 39(3), 113–119. http://dx.doi.org/10.21924/cst.6.1.2021.344
Lee, S. (2022). Effect of electronic medical record quality on nurses’ perceived usefulness and ease of use. CIN: Computers, Informatics, Nursing, 40(8), 562–570. https://doi.org/10.1097/cin.0000000000000845
Lee, S., & Lee, M.-S. (2021). Nurses’ electronic medical record workarounds in a tertiary teaching hospital. CIN: Computers, Informatics, Nursing, 39(7), 367–374. https://doi.org/10.1097/cin.0000000000000692
Murphy, P., & Carter-Templeton, H. (2023). Nurses’ ease-of-use ratings of the electronic medical record in the care of persons with heart failure. CIN: Computers, Informatics, Nursing, 41(5), 261–265. https://doi.org/10.1097/cin.0000000000001020
Naamneh, R., & Bodas, M. (2024). The effect of electronic medical records on medication errors, workload, and medical information availability among qualified nurses in Israel–a cross sectional study. BMC Nursing, 23(1), 270. https://doi.org/10.1186/s12912-024-01936-7
Njane, A., Jedwab, R., Calvo, R., Dobroff, N., Glozier, N., Hutchinson, A., … Rawson, H. (2021). Perioperative Nurses’ Perceptions Pre-Implementation of an Electronic Medical Record System. In Nurses and Midwives in the Digital Age (pp. 522–527). IOS Press. https://doi.org/10.3233/shti210787
Osajiuba, S. A., Jedwab, R., Calvo, R., Dobroff, N., Glozier, N., Hutchinson, A., … Redley, B. (2021). Facilitators and barriers to the adoption of an electronic medical record system by intensive care nurses. In Nurses and Midwives in the Digital Age (pp. 510–515). IOS Press. https://doi.org/10.3233/shti210785
Özer, Ö., & Şantaş, F. (2020). Effects of electronic medical records on patient safety culture: The perspective of nurses. Journal of Evaluation in Clinical Practice, 26(1), 72–78. https://doi.org/10.1111/jep.13174
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., … Brennan, S. E. (2021). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Bmj, 372. https://doi.org/10.1136/bmj.n71
Pandya, C., Clarke, T., Scarsella, E., Alongi, A., Amport, S. B., Hamel, L., & Dougherty, D. (2019). Ensuring effective care transition communication: Implementation of an electronic medical record–based tool for improved cancer treatment handoffs between clinic and infusion nurses. Journal of Oncology Practice, 15(5), e480–e489. https://doi.org/10.1200/jop.18.00245
Raghunathan, K., McKenna, L., & Peddle, M. (2021). Use of academic electronic medical records in nurse education: a scoping review. Nurse Education Today, 101, 104889. https://doi.org/10.1016/j.nedt.2021.104889
Shala, D. R., Jones, A., Alexander, N., Young, S., & Fairbrother, G. (2021). Responding to the Challenge of a Pandemic: The Rapid Conversion of Electronic Medical Record Training for Nurses From Classroom-Based Instructional Learning to a Blended Learning Approach in a Large Multisite Organization. CIN: Computers, Informatics, Nursing, 39(4), 171–175. https://doi.org/10.1097/cin.0000000000000735
Wynter, K., Holton, S., Nguyen, L., Sinnott, H., Wickramasinghe, N., Crowe, S., & Rasmussen, B. (2021). Nurses’ and midwives’ experiences of the first phase of the implementation of an electronic medical records system. Australian Health Review, 46(2), 188–196. https://doi.org/10.1071/ah21118
Copyright (c) 2025 Journal La Medihealtico
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
