The use of electronic health records by hospital bedside nurses can improve the quality of care provided without increasing direct costs, according to a new study in the Journal of Nursing Administration.
The researchers conducted a retrospective analysis in a 431 bed urban hospital with 10 medical/surgical units and two critical care units. They measured the impact of implementing an integrated EHR on the quality of nursing care--reviewing hospital-acquired falls, hospital-acquired pressure ulcers, ventilator associated pneumonia (VAP), central line associated blood stream infections (CLABSI) and catheter associated urinary tract infections (CAUTI).
They found that EHR adoption had an overall positive effect without increasing costs. The rates for falls, CAUTI and CLABSI fell; for instance, the rate of falls declined 15 percent. The ulcer and VAP rates saw negative results at implementation but then followed with a significant rate reduction that surpassed the rate in the preimplementation period. Moreover, the costs were initially negatively impacted but returned to the baseline.
The only longer-term negative was that nurse turnover increased significantly. This could have been due to a number of factors, such as sophistication of the user or EHR, or inadequate staffing during EHR adoption.
The researchers recommended that further research be conducted on what tools could enhance electronic documentation, how nurses can use EHRs for decision making and to identify turnover risks. They also suggested that hospitals increase nurse staffing during EHR implementation.
“The ability to have nurses possess [electronic evidenced based practice] tools at the point-of-care delivery informs their practice and allows for improved decision-making. This study supports the emerging relationship between the use of EHR functionality and the importance for nurses to lead quality improvement initiatives such as the use of the electronic information to improve critical thinking to deliver quality patient care,” the researchers concluded.
To learn more:
- read the study abstract