Nursing Reflection: Electronic Health Records and Practice

This nursing reflection essay explores the author's personal and professional views on Electronic Health Records (EHR) within the healthcare context. It utilizes the Gibbs Reflective Cycle to analyze experiences and insights regarding EHR implementation, including the importance of training, security measures, and confidentiality. The essay evaluates the existing literature on EHR, examining both its advantages, such as improved communication and reduced medical errors, and its challenges, like the lack of adequate training and potential privacy breaches. The analysis focuses on the impact of EHR on nursing practice, especially concerning the potential for breaches in patient confidentiality and the need for nurses to understand security protocols. Finally, the essay proposes strategies for practice, such as introducing e-health modules in nursing curricula and advocating for nursing leadership to leverage e-health technologies to improve patient care. The conclusion emphasizes the need for training, adherence to protocols, and maintaining the security and confidentiality of protected health information.

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

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Introduction
An electronic health record or a digitalized health record is a digital version of the
patient’s paper chart. This provides real time patient centred records which makes the
information accessible immediately and securely to the authorised users. An EHR does not
contain the treatment and the medical history of the patient. EHR contains the medical history
of a patient, the treatment plans, immunization dates, radiology images, laboratory and the
test results. It provides an automated and streamlined provider workflow. It promotes a
greater ad seamless flow of the information within a digital care infrastructure that is created
by the electronic heath records. Again, Electronic health records have made it possible to
improve the communication between the health care professionals, intended for the research,
legal processes and audits (da Costa & Linch, 2020). It has been found in various surveys
that the nurses have not yet got sufficient training on the information technology system. This
fact have encouraged me to take up this topic for self –reflection. Being a nurse, it is my duty
to help health care setting to adopt the e-health records. I will use the framework of Gibb’s
reflection for doing the reflection.
Personal and Professional self-reflection
I personally believe that electronic health record is one of the greatest inventions in
medical science. Large health organisations and the government agencies have been
recognizing the value of the EHR for the determination of the optimal patterns of care.
Additionally, as per my knowledge the EHR used previously were much difficult to
understand and handle. But with time, everything has been simplified and has been made user
friendly (Boonstra, Versluis & Vos, 2014). EHR records are now being designed, modified,
used and viewed by various independent organsations that included the primary care
clinicians, insurance houses and the hospitals. I have seen how the EHR are being used in the

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primary care exam rooms for documentation The health care providers are now utilizing
order sets, recognition of voice, documentation and barcordes for entering information
directly in to the EHR. The decision support norms and the computerised provider order entry
(CPOE) are also used regularly (Adams, 2015). Nowadays, the mobile devices having high
resolution cameras are also used by the healthcare professionals for capturing the pictures
from the bedside an incorporate them in to the EHR. I have personally gone through recent
papers and have found out that EHR widely improves communication between the health
care providers and the other hospital staffs, as everything is just a one click away. All the
information of a particular patient can be obtained at a go. Hence, we the nurses will not have
to deal with a number of papers. There is less chance of paper getting misplaced and this of
course reduced the chance of medical errors taking place. Again, transferring of the patient
information has been made lot easier by EHR as they can be exchanged via wide range of
techniques like emails and multiple facilities (Adams, 2015). They are also been used in the
home health and in the hospice services for recording the patient services. However,
implementation of the electronic health care records can be difficult to implement as many
current health care professionals got their educational training before the explosion of the
information technology and providing training to this group might become difficult. Again, I
cannot deny the genuine barriers towards the implementation of the EHRs, as many of the
hospitals still have not transformed or have not upgraded from the use of hard copy of records
to computerised health records. The EHR transformation is quite an expensive transformation
as it ranges from buying of the computers, printers and the other hard wares that are required
(Adams, 2015). I also feel that the clinicians do not possess enough knowledge about the
security measures that needs to be followed in order to prevent breaching of confidentiality of
the patient information. Another important issue related to the e-health technology that feels
concerning to me, is the confidentiality issue related to the e-health technologies. Security

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breaches in the cyber cloud threatens the privacy of the patient when the confidential health
information is made available to the others. The details of which will be discussed in the
following sections.
Evaluation
In the previous section, I have discussed about some of the issues which I consider to
be crucial for nurses associated to the use of e-health technologies are the lack of awareness
and training among the health care workers about its use, lack of proper funding to develop a
full-fledged e-health service and compromised confidentiality in the sharing of the electronic
health records.
It has been stated by Ozair, Jamshed, Sharma and Aggarwal (2015) that the health
care organisations and the health care institutions will need to access the EHR data and the
key to preserve the confidentiality is to only permit the authorised personnel to get access to
the information. This needs to begin with the authorisation of the users. According to a
survey, about 70 % of the physicians’ messages other physicians about patient information.
Mobile devices are for personal use and can be misplaced or damaged. Hence, Boonstra,
Versluis and Vos, (2014) have emphasised on the encryption of the mobile devices, that are
normally used for the transfer of confidential information. Varieties of security measures like
use of the antivirus software and software that can prevent intrusion can be used. Literatures
like Salameh et al., (2016) informs about usefulness of random audits that needs to be done
on a regular basis for ensuring the compliance with the hospital policy.
According to Habibi-Koolaee, Safdari and Bouraghi, (2015), lack of participation
among the users like nurses, are the prime factors for the failure of the information system, as
well as less investment of the resources about the readiness of the users to accept the changes
and the implementation of the EHR. Nurses play an import the role in order to provide

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clinical care and plays a valuable role in the implementation of the electronic health records.
The readiness of manpower is necessary for the successful implementation of the EHR.
I have also expressed my concern with the lack of proper training for the nurses,
before a successful implementation of the nurses. My thoughts can be supported with the
literature by (Al-Huneiti et al., (2016), where it has been stated the nursing curriculum needs
to be instilled with purposeful e-health contents for ensuring that the healthcare professionals
in future are prepared well to work in health care facilities, which is technologically driven.
Analysis
Analysing the feelings and what literature have stated, it can be stated that one of the
greatest issue that each nursing should be aware of the E- health technology is about the
privacy and the confidentiality breaches. Many of the current heath care systems both system-
wide and at the facility level, is experiencing changes related to the use of EHR.
Nurses , being the largest number of employees in the acute care settings, it is
necessary to understand , how effectively does nurses are able to use the HER and this has
potential impact on the care of the patient. According to Kruse et al., (2016), while e-health is
one of the greatest evolution in the healthcare, but the cyber security methods related to the
adoption of the EHR needs to be understood in details before moving forward. Due to the
sensitive nature of the health information is stored in the electronic health records. There are
several aspects of security for the technology that should be provided- physical, technical and
administrative. The nurses should be able to abide all the security measures to handle e-
health technologies. Kruse et al., (2018) have focussed on how the nurses feel about the EHR.
It has been found to improve the clinical documentation that threatens the confidentiality.
Miller et al., (2014) have supported the fact, that most important barrier for the
implementation of the EHR is the lack of education. Some of the percentages have expressed

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negative attitudes like EHR increases the workload and timing and is mainly associated with
high cost related to the assembly of the equipment required for setting up of the EHR. Al-
Huneiti et al., (2016) have conducted an analysis for the nursing the curriculum for the
various countries for evaluating whether the nurses are properly trained about ICT. It has
been found that there is an absence of systematic teaching in the e-health and e-nursing. This
can make it difficult for the nurses to assist with information and the communication
technologies (ICT).
Strategies for practice
Based on the analysis and the evaluation of the literature it can be stated that before
the implementation of the e-health technologies, there are certain interventions that needs to
be taken, for example, e-health nursing module needs to be introduced in to the nursing
curricula. Moreover, it is also felt that nursing leadership is an appropriate position within the
health care industry for taking the prime role in leveraging the e- health technologies for
enhancing the quality of the patient care (Boonstra, Versluis & Vos, 2014). All the nurses
needs to be aware of the HIPAA rules and should inform to the responsible IT personal, if
any they can guess any IT breach. They should be possess enough knowledge about the use
of security measures like the application of the passwords and updating of the fire walls
(Boonstra, Versluis & Vos, 2014).
Conclusion
In conclusion, it can be stated that one will totally agree the use of e-health
technologies starting from the use of the electronic health records to the use of the electronic
barcodes, as they tend to lessen down the rate of medical errors, reduces less time in keeping
and finding paper copies and are easier to the sent them to the patients. Some of essential
factors that is of major concern regarding the introduction of e-health is lack of training and

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education among the nurses about the use, maintaining proper protocols. The IT professionals
should follow the protocol to ensure that the databases are well secured and confidentiality
and security of the protected health information needs to be maintained. Finally, it is
necessary to introduce e- health education in the nursing modules.

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References
Adams, S. L. (2015). Nurses Knowledge, Skills, and Attitude Toward Electronic Health
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Al-Huneiti, R., Hunaiti, Z., Al-Masaeed, S., Balachandran, W., & Mansour, E. (2016).
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