scholarly journals Acute care nurses’ perceptions of electronic health record use: A mixed method study

Nursing Open ◽  
2018 ◽  
Vol 5 (4) ◽  
pp. 491-500 ◽  
Author(s):  
Gillian Strudwick ◽  
Linda McGillis Hall ◽  
Lynn Nagle ◽  
Patricia Trbovich
Keyword(s):  
Electronic Health Record ◽  
Acute Care ◽  
Mixed Method ◽  
Mixed Method Study ◽  
Health Record ◽  
Acute Care Nurses ◽  
Electronic Health ◽  
Nurses Perceptions

scholarly journals Potential of an Electronic Health Record-Integrated Patient Portal for Improving Care Plan Concordance during Acute Care

2019 ◽  
Vol 10 (03) ◽  
pp. 358-366 ◽  
Author(s):  
Anuj K. Dalal ◽  
Patricia Dykes ◽  
Lipika Samal ◽  
Kelly McNally ◽  
Eli Mlaver ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Acute Care ◽  
Transitions Of Care ◽  
Care Plan ◽  
Health Record ◽  
Patient Portal ◽  
Intention To Treat ◽  
Electronic Health ◽  
The Impact ◽  
Treat Analysis

Background Care plan concordance among patients and clinicians during hospitalization is suboptimal. Objective This article determines whether an electronic health record (EHR)-integrated patient portal was associated with increased understanding of the care plan, including the key recovery goal, among patients and clinicians in acute care setting. Methods The intervention included (1) a patient portal configured to solicit a single patient-designated recovery goal and display the care plan from the EHR for participating patients; and (2) an electronic care plan for all unit-based nurses that displays patient-inputted information, accessible to all clinicians via the EHR. Patients admitted to an oncology unit, including their nurses and physicians, were enrolled before and after implementation. Main outcomes included mean concordance scores for the overall care plan and individual care plan elements. Results Of 457 and 283 eligible patients approached during pre- and postintervention periods, 55 and 46 participated in interviews, respectively, including their clinicians. Of 46 postintervention patients, 27 (58.7%) enrolled in the patient portal. The intention-to-treat analysis demonstrated a nonsignificant increase in the mean concordance score for the overall care plan (62.0–67.1, adjusted p = 0.13), and significant increases in mean concordance scores for the recovery goal (30.3–57.7, adjusted p < 0.01) and main reason for hospitalization (58.6–79.2, adjusted p < 0.01). The on-treatment analysis of patient portal enrollees demonstrated significant increases in mean concordance scores for the overall care plan (61.9–70.0, adjusted p < 0.01), the recovery goal (30.4–66.8, adjusted p < 0.01), and main reason for hospitalization (58.3–81.7, adjusted p < 0.01), comparable to the intention-to-treat analysis. Conclusion Implementation of an EHR-integrated patient portal was associated with increased concordance for key care plan components. Future efforts should be directed at improving concordance for other care plan components and conducting larger, randomized studies to evaluate the impact on key outcomes during transitions of care. Clinical Trials Identifier NCT02258594.

scholarly journals Hospital adoption of electronic health record functions to support age-friendly care: results from a national survey

2020 ◽  
Vol 27 (8) ◽  
pp. 1206-1213 ◽  
Author(s):  
Julia Adler-Milstein ◽  
Katherine Raphael ◽  
Alice Bonner ◽  
Leslie Pelton ◽  
Terry Fulmer
Keyword(s):  
Older Adults ◽  
Electronic Health Record ◽  
Acute Care ◽  
Long Term Care ◽  
Health Record ◽  
Care Hospital ◽  
Term Care ◽  
Care Facilities ◽  
Electronic Health

Abstract Objective To measure US hospitals’ adoption of electronic health record (EHR) functions that support care for older adults, focusing on structured documentation of the 4Ms (What Matters, Medication, Mentation, and Mobility) and electronic health information exchange/communication with patients, caregivers, and long-term care providers. Materials and Methods In an online survey of a national, random sample of 797 US acute-care hospitals in 2018–2019, 479 (60.1%) responded. We calculated nationally representative measures of the percentages of hospitals with EHRs that include structured documentation of the 4Ms and exchange/communications functions. Results Structured EHR documentation of the 4Ms was fully implemented in at least 1 unit in 64.0% of hospitals and across all units in 41.5% of hospitals. Of the 4Ms, structured documentation was the highest for medications (91.3% in at least 1 unit) and the lowest for mentation (70.3% in at least 1 unit). All exchange/communication functions had been implemented in at least 1 unit in 16.2% of facilities and across all units in 7.6% of hospitals. Less than half of the hospitals had an EHR portal for long-term care facilities to access hospital information (45.4% in at least 1 unit), sent information electronically to long-term care facilities (44.6%), and had training for adults/caregivers on the patient portal (32.1%). Discussion Despite significant national investment in EHRs, hospital EHRs do not yet include key documentation, exchange, and communication functions needed to support evidence-based care for the older adults who comprise the majority of the inpatient population. Additional policy efforts are likely needed to promote the expansion of EHR capabilities into these high-value domains. Conclusions US acute-care hospital EHRs are lacking key functions that support care for older adults.

scholarly journals Perception of emergency nurses on electronic health record (Cerner) in acute-care setting

2016 ◽  
Vol 2016 (2) ◽  
pp. 107
Author(s):  
Gloria Culla Macatangay ◽  
Ma. Teresita Caritativo ◽  
Hashem Mestarihi ◽  
Grethel Dela Paz ◽  
Ahmed Torkzi
Keyword(s):  
Electronic Health Record ◽  
Acute Care ◽  
Care Setting ◽  
Health Record ◽  
Acute Care Setting ◽  
Emergency Nurses ◽  
Electronic Health

scholarly journals Harnessing the Electronic Health Record to Actively Support Providers with Guideline-Directed Telemetry Use

2021 ◽  
Vol 12 (05) ◽  
pp. 996-1001
Author(s):  
Maya Narayanan ◽  
Helene Starks ◽  
Eric Tanenbaum ◽  
Ellen Robinson ◽  
Paul R. Sutton ◽  
...  
Keyword(s):  
Electronic Health Record ◽  
Acute Care ◽  
Low Cost ◽  
Heart Association ◽  
Evidence Based ◽  
Health Record ◽  
Post Intervention ◽  
Support Providers ◽  
Electronic Health ◽  
The Impact

Abstract Background Overuse of cardiac telemetry monitoring (telemetry) can lead to alarm fatigue, discomfort for patients, and unnecessary medical costs. Currently there are evidence-based recommendations describing appropriate telemetry use, but many providers are unaware of these guidelines. Objectives At our multihospital health system, our goal was to support providers in ordering telemetry on acute care in accordance with evidence-based guidelines and discontinuing telemetry when it was no longer medically indicated. Methods We implemented a multipronged electronic health record (EHR) intervention at two academic medical centers, including: (1) an order set requiring providers to choose an indication for telemetry with a recommended duration based on American Heart Association guidelines; (2) an EHR-generated reminder page to the primary provider recommending telemetry discontinuation once the guideline-recommended duration for telemetry is exceeded; and (3) documentation of telemetry interpretation by telemetry technicians in the notes section of the EHR. To determine the impact of the intervention, we compared number of telemetry orders actively discontinued prior to discharge and telemetry duration 1 year pre- to 1 year post-intervention on acute care medicine services. We evaluated sustainability at years 2 and 3. Results Implementation of the EHR initiative resulted in a statistically significant increase in active discontinuation of telemetry orders prior to discharge: 15% (63.4–78.7%) at one site and 13% at the other (64.1–77.4%) with greater improvements on resident teams. Fewer acute care medicine telemetry orders were placed on medicine services across the system (1,503–1,305) despite an increase in admissions and the average duration of telemetry decreased at both sites (62 to 47 hours, p < 0.001 and 73 to 60, p < 0.001, respectively). Improvements were sustained 2 and 3 years after intervention. Conclusion Our study showed that a low-cost, multipart, EHR-based intervention with active provider engagement and no additional education can decrease telemetry usage on acute care medicine services.

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