Descriptions of nurses' experiences with electronic health records (EHR): A phenomenological study

The overall goal of this dissertation study was to explore and describe the lived experiences of nurses working with Electronic Health Records (EHR). Since U.S. President Bush’s 2004 mandate to put EHRs in place by 2014, EHR design and implementation have become priorities for all health care organizations. Research studies of EHR implementation and utilization found in the literature reveal a fifty-percent failure rate among organizations and institutions that attempt to adopt and sustain EHR use in their facilities.\r\nWhile nurses are the largest group of health care providers who use health information systems and can influence their adoption and utilization outcomes, few nurses have been included in planning, researching, and implementing the EHR. Several studies report nurses’ uses of computers in the workplace, however few have examined the subjective lived experiences of nurses whose daily work is affected by organizational, technological, educational, and behavioral factors associated with EHR system conversion and implementation. The study reported here fills a gap in knowledge by adding the subjective lived experiences of EHR nurses to the larger body of knowledge that addresses information system changes and their influences upon nursing practice and patient care outcomes.\r\n \r\nUsing a phenomenology of practice research approach, a purposive sample of 14 nurses with EHR experiences was enrolled. Data were collected during interviews with the investigator until saturation and redundancy were achieved. Assigning code letters, interviewing participants in private places, and maintaining all study materials in locked files were methods used to protect identities and confidentiality. Interview data were transcribed, coded, and clustered during thematic analysis procedures guided by Martins (1992).\r\n\r\nFindings revealed three emergent themes that captured the meanings of the participants’ descriptions of Phases of EHR Experiences, Dimensions of EHR Influence, and Future Improvements. Twelve sub-themes supported by instances of data found in the narratives formed the knowledge used to induct the three themes. Truth value and scientific rigor of the study were evaluated using the standards of: (1) descriptive vividness, (2) methodological congruence, (3) analytical preciseness, (4) theoretical correctness, (5) heuristic relevance (Burns & Grove, 2005) and (6) Lincoln & Guba’s (1985) criteria of trustworthiness.\r\n \r\n