Mari Berge
Center for Care Research – Western Norway, Bergen University College, Faculty of Health and Social Sciences, Bergen, Norway
Mariann Fossum
Center for Caring Research – Southern Norway, Faculty of Health and Sports Sciences, University of Agder, Grimstad, Norway
Ann Fruhling
School of Interdisciplinary Informatics, College of Information Science and Technology, University of Nebraska, Omaha, USA
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Published in: Scandinavian Conference on Health Informatics 2012; October 2-3; Linköping; Sverige
Linköping Electronic Conference Proceedings 70:3, p. 13-18
Published: 2012-09-28
ISBN: 978-91-7519-758-6
ISSN: 1650-3686 (print), 1650-3740 (online)
The use of electronic health records (EHRs) to support health care has dramatically increased in the past several years; however; the efficiency of these systems in supporting nursing personnel’s workflow remains unclear. The purpose of this paper is to examine nurses’ experiences using an EHR system and how nursing personnel evaluate the usability of the EHR system. Three focus group interviews and a cognitive walkthrough with four nurses were performed in the spring of 2010. A major finding was that the nursing personnel were satisfied overall with the implemented EHR system. The most commonly mentioned problems were lack of training and organizational challenges during implementation. Strategies to improve the efficiency of EHRs were reducing the amount of information displayed and the number of opportunities to perform a certain task in the system.
1. The Ministry of Health & Care Services. Lov om helsepersonell [The Health Personnel Act] The Act of 2 July 1999 No. 64 relating to Health Personnell Oslo1999 [cited 2011 5 Dec]; Available from: http://www.lovdata.no/all/nl- 19990702-064.html.
2. The Ministry of Health & Care Services. Samhandlingsreformen: rett behandling - på rett sted - til rett tid [The Coordination Reform ]. Oslo: Helse- og omsorgsdepartementet [Ministry of Health & Care Services]; 2009. p. 149.
3. Rubin J; Chisnell D. Handbook of usability testing: how to plan; design; and conduct effective tests. Indianapolis; Ind.: Wiley Pub.; 2008.
4. Shneiderman B; Plaisant C. Designing the user interface: strategies for effective human-computer interaction. 5th ed. Boston: Addison-Wesley; 2010.
5. Urquhart C; Currell R; Grant MJ; Hardiker NR. Nursing record systems: effects on nursing practice and healthcare outcomes. Cochrane Database Syst Rev. 2009;1.
6. Fossum M; Ehnfors M; Fruhling AL; Ehrenberg A. An evaluation of the usability of a computerized decision support system for nursing homes. Appl Clin Inform 2011;2(4):420-36.
7. Krüger K; Strand L; Geitung J-T; Eide GE; Grimsmo A. Can electronic tools help improve nursing home quality? ISRN Nursing [Internet]. 2011 5 Jan 2012; 2011:[208142- pp.]. Available from: http://search.ebscohost.com/login.aspx?direct=true&db=cmed m&AN=22013540&site=ehost-live.
8. Kushniruk AW; Patel VL. Cognitive and usability engineering methods for the evaluation of clinical information systems. J Biomed Inform. 2004;37(1):56-76.
9. Alexander GL; Staggers N. A systematic review of the designs of clinical technology: findings and recommendations for future research. Adv Nurs Sci. 2009;32(3):252-79.
10. Lazar J; Feng JH; Hochheiser H. Research methods in human-computer interaction. West Sussex: John Whiley; 2010.
11. Elwyn G; Greenhalgh T; Macfarlane F; Koppel S. Groups: a guide to small group work in healthcare; management; education and research. Oxford: Radcliffe Medical Press; 2001.
12. Kvale S; Brinkmann S; Anderssen TM; Rygge J. Det kvalitative forskningsintervju [The Qualitative Research Interview]. Oslo: Gyldendal akademisk; 2009.
13. Brender J. Handbook of evaluation methods for health informatics. Amsterdam: Elsevier Academic Press; 2006.
14. Patton M. Qualitative Research & Evaluation Methods. 3rd ed. London: Sage; 2002.
15. Sandelowski M. Focus on research methods: Whatever happened to qualitative description? Res Nurs Health. 2000;23(4):334-40.
16. Mikkelsen G; Aasly J. Concordance of information in parallel electronic and paper based patient records. Int J Med Inf. 2001;63(3):123-31.
17. Rantz MJ; Hicks L; Petroski GF; Madsen RW; Alexander G; Galambos C; et al. Cost; staffing and quality impact of bedside electronic medical record (EMR) in nursing homes. J Am Med Dir Assoc. 2010;11(7):485-93.
18. Alexander GL; Rantz M; Flesner M; Diekemper M; Siem C. Clinical information systems in nursing homes: an evaluation of initial implementation strategies. CIN: Computers; Informatics; Nursing. 2007;25(4):189-97.
19. Andre B; Ringdal GI; Loge JH; Rannestad T; Kaasa S. The importance of key personnel and active management for successful implementation of computer-based technology in palliative care: results from a qualitative study. Comput Inform Nurs. 2008;26(4):183-9.
20. Ammenwerth E; Kutscha U; Kutscha A; Mahler C; Eichstädter R; Haux R. Nursing process documentation systems in clinical routine: prerequisites and experiences. Int J Med Inf. 2001;64(2-3):187-200.
21. Häyrinen K; Lammintakanen J; Saranto K. Evaluation of electronic nursing documentation--nursing process model and standardized terminologies as keys to visible and transparent nursing. Int J Med Inf. 2010;79(8):554-64.
22. Saranto K; Kinnunen U. Evaluating nursing documentation - research designs and methods: systematic review. J Adv Nurs. 2009;65(3):464-76.
23. Häyrinen K; Saranto K; Nykänen P. Definition; structure; content; use and impacts of electronic health records: A review of the research literature. Int J Med Inf. 2008;77(5):291-304.
24. Polit DF; Beck CT. Nursing research: generating and assessing evidence for nursing practice. Philadelphia; Pa.: Wolters Kluwer/Lippincott Williams & Wilkins; 2008.
