title: Barriers and facilitators to electronic documentation in a rural hospital.
abstract: OBJECTIVE
  The purpose of the study was to explore nurses' perceptions of barriers and facilitators to adoption of an electronic health record (EHR) in a rural Midwestern hospital.
  
  
  METHODS
  This study was a qualitative, descriptive design. The Staggers and Parks Nurse-Computer Interaction Framework was used to guide directed content analysis.
  
  
  METHODS
  Eleven registered nurses from oncology and medical-surgical units were interviewed using three semistructured interview questions. Predetermined codes and operational definitions were developed from the Staggers and Parks framework. Narrative data were analyzed by each member of the research team and group consensus on coding was reached through group discussions.
  
  
  RESULTS
  Participants were able to identify computer-related, nurse-related, and contextual barriers and facilitators to implementation of EHR. In addition, two distinct patterns of perceptions and acceptance were identified.
  
  
  CONCLUSIONS
  The Staggers and Parks Nurse-Computer Interaction framework was found to be useful in identifying computer, nurse, and contextual characteristics that act as facilitators or barriers to adoption of an EHR system. Acceptance and use of an EHR are enhanced when barriers are managed and facilitators are supported.
  
  
  CONCLUSIONS
  Understanding and management of facilitators and barriers to EHR adoption may impact nurses' ability to provide and document nursing care.
authors.affiliation: Creighton University School of Nursing, Hastings, NE 68901, USA. aliw@creighton.edu
authors.forename: Alice A
authors.initials: AA
authors.lastname: Whittaker
authors.forename: Marilee
authors.initials: M
authors.lastname: Aufdenkamp
authors.forename: Susan
authors.initials: S
authors.lastname: Tinley
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D001292:Attitude to Computers; D003197:Computer Literacy; D003200:Computer User Training; D034201:Computers, Handheld; D004059:Diffusion of Innovation; D004282:Documentation; D004509:Education, Nursing, Continuing; D057286:Electronic Health Records / Q000458:organization & administration*; D005260:Female; D006780:Hospitals, Rural / Q000458:organization & administration; D006801:Humans; D008875:Middle Aged; D015146:Midwestern United States; D016294:Models, Nursing; D008960:Models, Psychological; D020380:Needs Assessment; D015404:Nursing Methodology Research; D009737:Nursing Records; D009741:Nursing Staff, Hospital / Q000193:education / Q000458:organization & administration / Q000523:psychology*; D019095:Point-of-Care Systems / Q000458:organization & administration*; D036301:Qualitative Research; D014584:User-Computer Interface