title: Electronic medical records, nurse staffing, and nurse-sensitive patient outcomes: evidence from the national database of nursing quality indicators.
abstract: Electronic medical records (EMR) have the potential to improve nursing care in the hospital setting. This study estimated the association of EMR implementation with nurse staffing levels, skill mix, contract/agency percent, and nurse-sensitive patient outcomes in U.S. hospitals. Data on nurse staffing and patient outcomes came from the 2004-2008 National Database of Nursing Quality Indicators. Data on EMR implementation came from the 2004-2008 HIMSS Analytics Database. The authors conducted a longitudinal analysis of an unbalanced panel of 3,048 medical/surgical units in 509 short-term, general acute care hospitals. EMR implementation was associated with lower total nurse hours per patient day, higher Registered Nurse percent and contract/agency percent, and higher adverse patient events in the short term. EMR may create a skill bias toward higher-skilled nurses. As more advanced EMR systems diffuse into practice, managers and policy makers should consider potential negative associations of EMR implementation with patient safety.
authors.affiliation: Arizona State University, Tempe, AZ 85287-4606, USA. Michael.Furukawa@asu.edu
authors.forename: Michael F
authors.initials: MF
authors.lastname: Furukawa
authors.forename: T S
authors.initials: TS
authors.lastname: Raghu
authors.forename: Benjamin B M
authors.initials: BB
authors.lastname: Shao
mesh_terms: D016208:Databases, Factual / Q000706:statistics & numerical data; D057286:Electronic Health Records; D006801:Humans; D008137:Longitudinal Studies; D009732:Nursing Care / Q000592:standards*; D009741:Nursing Staff, Hospital / Q000592:standards*; D017063:Outcome Assessment, Health Care / Q000379:methods* / Q000706:statistics & numerical data; D019984:Quality Indicators, Health Care / Q000592:standards; D014481:United States