Journal article
Nurse workarounds in the electronic health record: An integrative review
Journal of the American Medical Informatics Association : JAMIA, Vol.27(7), pp.1149-1165
07/01/2020
DOI: 10.1093/jamia/ocaa050
PMCID: PMC7647365
PMID: 32651588
Abstract
Objective: The study sought to synthesize published literature on direct care nurses' use of workarounds related to the electronic health record.
Materials and Methods: We conducted an integrative review of qualitative and quantitative peer-reviewed research through a structured search of Academic Search Complete, EBSCO Cumulative Index of Nursing and Allied Health Literature (CINAHL), Embase, Engineering Village, Ovid Medline, Scopus, and Web of Science. We systematically applied exclusion rules at the title, abstract, and full article stages and extracted and synthesized their research methods, workaround classifications, and probable causes from articles meeting inclusion criteria.
Results: Our search yielded 5221 results. After removing duplicates and applying rules, 33 results met inclusion criteria. A total of 22 articles used qualitative approaches, 10 used mixed methods, and 1 used quantitative methods. While researchers may classify workarounds differently, they generally fit 1 of 3 broad categories: omission of process steps, steps performed out of sequence, and unauthorized process steps. Each study identified probable causes, which included technology, task, organizational, patient, environmental, and usability factors.
Conclusions: Extensive study of nurse workarounds in acute settings highlights the gap in ambulatory care research. Despite decades of electronic health record development, poor usability remains a key concern for nurses and other members of care team. The widespread use of workarounds by the largest group of healthcare providers subverts quality health care at every level of the healthcare system. Research is needed to explore the gaps in our understanding of and identify strategies to reduce workaround behaviors.
Details
- Title: Subtitle
- Nurse workarounds in the electronic health record: An integrative review
- Creators
- Dan Fraczkowski - University of Illinois Urbana-ChampaignJeffrey Matson - Northwestern Memorial HospitalKaren Dunn Lopez - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Journal of the American Medical Informatics Association : JAMIA, Vol.27(7), pp.1149-1165
- DOI
- 10.1093/jamia/ocaa050
- PMID
- 32651588
- PMCID
- PMC7647365
- NLM abbreviation
- J Am Med Inform Assoc
- ISSN
- 1067-5027
- eISSN
- 1527-974X
- Publisher
- Oxford Univ Press
- Number of pages
- 17
- Language
- English
- Date published
- 07/01/2020
- Academic Unit
- Nursing
- Record Identifier
- 9984370631002771
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