title: Connecting Professional Practice and Technology at the Bedside: Nurses' Beliefs about Using an Electronic Health Record and Their Ability to Incorporate Professional and Patient-Centered Nursing Activities in Patient Care.
abstract: The purpose of this research is to determine the effects of implementing an electronic health record on medical-surgical registered nurses' time spent in direct professional patient-centered nursing activities, attitudes and beliefs related to implementation, and changes in level of nursing engagement after deployment of the electronic health record. Patient-centered activities were categorized using Watson's Caritas Processes and the Relationship-Based Care Delivery System. Methods included use of an Attitudes and Beliefs Assessment Questionnaire, Nursing Engagement Questionnaire, and Rapid Modeling Corporation's personal digital assistants for time and motion data collection. There was a significant difference in normative belief between nurses with less than 15 years' experience and nurses with more than 15 years' experience (t21 = 2.7, P = .01). While nurses spent less time at the nurses' station, less time charting, significantly more time in patients' rooms and in purposeful interactions, time spent in relationship-based caring behavior categories actually decreased in most categories. Nurses' engagement scores did not significantly increase. These results serve to inform healthcare organizations about potential factors related to electronic health record deployment which create shifts in nursing time spent across care categories and can be used to explore further patient centered care practices.
authors: Author Affiliations: Bon Secours Health System, Inc, Center for Clinical Excellence and Innovation, Marriottsville, Maryland.
authors: Melissa
authors: M
authors: Gomes
authors: Pamela
authors: P
authors: Hash
authors: Liana
authors: L
authors: Orsolini
authors: Aimee
authors: A
authors: Watkins
authors: Andrea
authors: A
authors: Mazzoccoli
mesh_terms: D001291:Attitude of Health Personnel; D057286:Electronic Health Records / Q000706:statistics & numerical data*; D006801:Humans; D009723:Nurse-Patient Relations; D009726:Nurses / Q000523:psychology*; D018802:Patient-Centered Care; D011364:Professional Practice; D011795:Surveys and Questionnaires; D013996:Time and Motion Studies