Critique of Quantitative Studies on EHR Impact on Nursing Care

This essay provides a critical appraisal of two quantitative research studies focusing on the impact of electronic health records (EHR) on nursing practice. It identifies the clinical problem of increasing healthcare demands and challenges, including the integration of technology like EHRs. The essay discusses AnneMarie Walker-Czyz's paper on EHR's significance in nursing, highlighting its strengths in using the DOI framework and weaknesses in establishing a clear EHR-nurse relationship. It also examines Phelps et al.'s study on Renal Patient View, noting its success in linking results to research questions but its failure to critique its own findings. The analysis includes PICOT questions for each study, ethical considerations, and the potential use of findings in nursing practice, concluding that EHR implementation reduces time spent on patient information management.

Running head: NURSING
Topic: NURSING
Name of the Student:
Name of the University:
Author Note:

1NURSING
Introduction
Over the years there has been an increased demand for the use of healthcare services
over the years and the challenges faced by the healthcare systems. Various challenges include
socio demographic changes, strained financial resources along with rising healthcare costs
(Kowitlawakul et al., 2015). Introduction and maintenance of information through computers
has affected the perceived methods for the provision of effective patient care along with
another factors directed at the focus on the adaptation of technologies. This essay would
highlight the critical appraisal of the two quantitative methods of the result of implementing
electronic health records (EHR) in health care and the significance of EHR in nursing
practice.
Discussion
The clinical problem identified in the given assignment is the effect of electronic
health records in Healthcare and their effect on nursing practices. The following paper by
(AnneMarie Walker-Czyz, 2014) focuses on the use of the electronic health record tool and
its significance in the nursing practice. Moreover the main thesis of this paper has been
directed towards exploring the quality outcomes including cost, hospital acquired conditions
and nurses turnover.
PICOT question: Does the implementation of electronic health records lead to the
improvement of nursing performance within a short time period?
P- Population: Nurses in patient hospital settings
I-Intervention: Electronic health records (EHR) through documentation of data
C-Comparison: Absence of EHR by other health professional than the nursing staff
O- Outcome: Improved Nursing performance of the nurses through self-reporting and self-
awareness
T- Time: not mentioned after patient data documentation

2NURSING
Regarding identification of the research problem, the author has been successful in
measuring the various impacts of the effect of electronic health records and is innovative
adoption on the kind of nursing care developed. Considering the establishment of the
significance of the study the author has highlighted the adoption of EHR for the improvement
of healthcare performance. Moreover, nursing have been a complex profession requiring the
competence and the professionalism in delivery of care which has affected the quality of care
given to patients. Regarding the identification of the purpose of the study the author has been
successful in clearly pointing out the lack of proper resources in the healthcare industry
which has caused limited supply of care to the patients effecting the kind of care received by
them (Kowitlawakul et al., 2015). The author has also successfully pointed out the strengths
and weakness of the paper as the implementation methods has not been well controlled and it
has caused a number of outcomes. The strength has been the use of a proper DOI framework
for investigating the factors affecting implementation of a documentation tool. The author has
clearly demonstrated the research obtained from secondary sources. Statistical procedures
like regression analysis has been done and the implementation of EHRs with the commitment
of the nurses. Moreover there has been a negative relation to the engagement. The various
factors affecting the direct practice of nurses has also been mentioned. However the weakness
of the paper lies in the fact that the author has not clearly established a relation between the
implementation of EHRs and the nurses and has digressed from the topic taking many other
factors into considered. Overall, the author has been successful in criticizing the paper
pointing the strengths and weakness and explaining the various aspects of the implementation
of the computerized health records on people as indicated. Research studies by Carayon et al
(2015) have found that implementation of electronic health records have a positive impact on
the distribution of tasks along with temporal pattern which affects the efficiency of nursing
practices supporting the author in his main findings.

3NURSING
According to the paper by Phelps et al (2015) the effect of Renal Patient View, a kind
of electronic health record system has been established through the responses of the patients
through quantitative studies.
PICOT question: Does the implementation of electronic health records like Renal Patient
View (RPV) lead to the improvement of nursing performance?
P- Population: Nurses in the hospital settings
I-Intervention: Electronic health records (EHR) implemented in the hospitals through
documentation of the patient data
C-Comparison: Absence of EHR in comparison to the data documented by the patient’s
information
O- Outcome: Improved Nursing performance of the nursing staff through formation of an
established therapeutic relationship and holistic approach
T- Time: Based on deprivation studies of the pateints
Firstly the author has clearly shown the research using the segmentation of the methods for
the paper inclusive of objective, methods and results which have been clearly mentioned. The
main research question of the investigation of RPV as a kind of health record has been clearly
specified. The methods, have included the kind of studies done based on the analysis of the
anonymized extract of the database including the access of the patient and the arrival of the
letters that the patients have chosen to view. The results have been specified using logon
analysis and the author has used tie based study based on the registration records. Data
collection has been found on the basis of deprivation scores. Deprivation range has been
subsequently found. The classification of people registering for the EHR have depended on
the based on census date. The author has also categorized the records depending on the
number of patients registered for the health records electronically. From the following results
the author has clearly linked the results with the research question which states that there has

4NURSING
been a high rate of the use of the health records. Moreover there has been access for timely
blood test results for renal patient view. Time management has also been a factor for the
preferred use of the health records by the patients (Wald et al., 2014). Then analysis and
graphs have done on the deprivation along with the number of patients registering for the
methods. Overall, the author has successfully criticized the paper on the basis of the
preference of patients based on the health records. However this paper fails to criticize the
findings and point out the factors lacking in the paper. Other works by King et al (2014) have
performed a systematic view which has identified cost issues, lack of time and workload
various concerns which would support the findings. Other research done on the changes in
the cognitive workload of nurses in the healthcare industry have found that there is an
increased workload for the nurses especially during the early phases of HER transitions
where the health systems often anticipate variability among the workers adapting to the
system (Colligan et al., 2015).
Conclusion
From the following paragraphs it can be understood that implementation of electronic
health records have played an important part in reducing the time taken by nurses for
arranging patient information. Both the papers have quantitatively criticized the effect of
various health record systems and the view of the patients regarding the implementation ad
their effectiveness in nursing practices.

5NURSING
References
AnneMarie Walker-Czyz. (2014). The Impact of an Integrated Electronic Health Record
Adoption on the Quality of Nursing Care Delivered [Ebook]. AnneMarie Walker-
Czyz. Retrieved from https://fisherpub.sjfc.edu/cgi/viewcontent.cgi?
article=1191&context=education_etd
Bayliss, E. A., Ellis, J. L., Shoup, J. A., Zeng, C., McQuillan, D. B., & Steiner, J. F. (2015).
Effect of continuity of care on hospital utilization for seniors with multiple medical
conditions in an integrated health care system. The Annals of Family Medicine, 13(2),
123-129. doi: 10.1370/afm.1739
Carayon, P., Wetterneck, T. B., Alyousef, B., Brown, R. L., Cartmill, R. S., McGuire, K., ...
& Weinger, M. B. (2015). Impact of electronic health record technology on the work
and workflow of physicians in the intensive care unit. International journal of
medical informatics, 84(8), 578-594.doi.org/10.1016/j.ijmedinf.2015.04.002
Colligan, L., Potts, H. W., Finn, C. T., & Sinkin, R. A. (2015). Cognitive workload changes
for nurses transitioning from a legacy system with paper documentation to a
commercial electronic health record. International journal of medical
informatics, 84(7), 469-476. oi.org/10.1016/j.ijmedinf.2015.03.003
doi.org/10.1186/1741-7015-9-46
King, J., Patel, V., Jamoom, E. W., & Furukawa, M. F. (2014). Clinical benefits of electronic
health record use: national findings. Health services research, 49(1pt2), 392-404.
doi.org/10.1111/1475-6773.12135
Kowitlawakul, Y., Chan, S. W. C., Pulcini, J., & Wang, W. (2015). Factors influencing
nursing students' acceptance of electronic health records for nursing education
(EHRNE) software program. Nurse Education Today, 35(1), 189-194.
doi.org/10.1016/j.nedt.2014.05.010

6NURSING
Phelps, R. G., Taylor, J., Simpson, K., Samuel, J., & Turner, A. N. (2014). Patients’
continuing use of an online health record: a quantitative evaluation of 14,000 patient
years of access data. Journal of medical Internet research, 16(10), e241.
Wald, H. S., George, P., Reis, S. P., & Taylor, J. S. (2014). Electronic health record training
in undergraduate medical education: bridging theory to practice with curricula for
empowering patient-and relationship-centered care in the computerized
setting. Academic Medicine, 89(3), 380-386. doi: 10.1097/ACM.0000000000000131