Nursing Research and Evidence-Based Practice: EHR and Interaction

This report delves into the critical clinical problem of how the implementation of Electronic Health Records (EHR) affects the interaction between nurses and patients. The research utilizes a PICOT question to frame the investigation, focusing on nurses in adult in-patient hospital settings. It examines whether EHR usage improves nurse-patient communication and interaction within a year or more after implementation. The report acknowledges the advancements in technology and the shift in nursing roles, highlighting the incorporation of health informatics and EHRs for patient data documentation. It discusses the mixed opinions surrounding EHR, including the potential for improved communication, documentation, and reduced errors, while also addressing concerns about reduced therapeutic engagement and patient privacy. The research critically evaluates existing literature on the relationship between EHR usage and nursing performance, citing relevant studies and references to support its findings. The goal is to provide a comprehensive understanding of EHR's impact on nursing practice and patient care.

Running head: NURSING RESEARCH AND EVIDENCE BASED PRACTICE
NURSING RESEARCH AND EVIDENCE BASED PRACTICE
Name of the Student:
Name of the University:
Author note:

1NURSING RESEARCH AND EVIDENCE BASED PRACTICE
Clinical Problem and Nursing Issue: Effect of patient documentation using HER on nursing-
patient interaction.
PICOT Question: Does usage of electronic health records for the purpose of patient
documentation improve interaction and communication between the nurse and the patient within
an year or beyong after its implementation?
 P: Population: Nurses employed in adult in-patient hospital settings.
 I: Intervention: Documentation of Patient Data by nurses using Electronic Health
Records (EHR)
 C: Comparison: Documentation of patient data using EHR by health professionals other
than nurses, for example: physicians
 O: Outcome: Nurses’ self-reported perceptions on improvemetns in the nurse-patient
inetarction
 T: Time: One year or more, after implementation of EHR associated patient data
documentation
Summary of Clinical Issue
With the advancement of science and technology, the field of nursing has encountered
considerable changes in the nature of nursing roles and responsibilities. Nurses are now required
to perform a variety of diverse functions rather than merely engaging in alleviation of
physiological symptoms (Sweeney, 2017). Health informatics are an essential advancement in
the field of nursing and healthcare and involves the incorporation of information technology in
healthcare documentation and management of patient personal details. Electronic health records
(EHR) involves the conductance of patient detail documentation using computerized networks,

2NURSING RESEARCH AND EVIDENCE BASED PRACTICE
information technology and telemedicine (Rajkomar et al., 2018). Nurses are now required to
comply to such organizational changes and engage in regular documentation of required patient
characteristics using EHR. However, implementation of such practices is currently undergoing a
multifaceted response where mixed opinions have emerged concerning the affect of EHR on
nursing performance (Chao et al., 2016). It has been advocated that nursing usage of HER, as
reported by nurses, improve their communication and nature of interaction resulting in positive
therapeutic relationships and a detailed patient data documentation which further leads to
reduction of medication errors, improved evaluation and follow ups and increased nursing
conductance of detailed adherence to patient details to enquiry (Yontz, Zinn & Schumacher,
2015). However, EHR usage has also been met with considerable criticism with nurses
expressing that the need for detailed and continuous documentation in such technology reduces
nursing therapeutic engagement with the patients and often raises issues of patient privacy due to
the risk of security breaches. Further nurses’ have often expressed a lack of adequate
understanding EHR usage resulting in perceptions of fear, incompetence and a resultant
hindrance to perform expected nursing duties. Hence, this research will seek to critically evaluate
existing literature on associations between EHR usage and nursing performance improvement
(Abbott, Fuji & Galt, 2015).

3NURSING RESEARCH AND EVIDENCE BASED PRACTICE
References
Abbott, A. A., Fuji, K. T., & Galt, K. A. (2015). A qualitative case study exploring nurse
engagement with electronic health records and e-prescribing. Western journal of nursing
research, 37(7), 935-951. doi: https://doi.org/10.1177%2F0193945914567359.
Chao, C. A. (2016). The impact of electronic health records on collaborative work routines: A
narrative network analysis. International journal of medical informatics, 94, 100-111.
doi: https://doi.org/10.1016/j.ijmedinf.2016.06.019.
Rajkomar, A., Oren, E., Chen, K., Dai, A. M., Hajaj, N., Hardt, M., ... & Sundberg, P. (2018).
Scalable and accurate deep learning with electronic health records. NPJ Digital
Medicine, 1(1), 18. doi: https://doi.org/10.1038/s41746-018-0029-1.
Sweeney, J. (2017). Healthcare Informatics. On-Line Journal of Nursing Informatics, 21(1).
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Yontz, L. S., Zinn, J. L., & Schumacher, E. J. (2015). Perioperative nurses' attitudes toward the
electronic health record. Journal of PeriAnesthesia Nursing, 30(1), 23-32. doi:
https://doi.org/10.1016/j.jopan.2014.01.007.