Building a robust information technology infrastructure has been recognized as integral in addressing national concerns about patient safety, healthcare quality, and healthcare costs. Federal efforts to promote the nationwide adoption and integration of electronic health records (EHRs) include the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009, which provided over $27 billion in federal incentives to healthcare organizations and providers to incorporate EHRs into healthcare practices. Medicare and Medicaid Electronic Health Record Incentive Programs, initiated in 2011, were enacted to expand EHR functionality, encourage EHR system upgrades, and establish nationwide use of certified EHR technology. Subsequently, EHRs have become a prominent part of healthcare informatics and delivery. However, registered nurses, as representatives of the largest group of healthcare professionals, are often overlooked in studies related to EHRs. Therefore, the purposes of this study are to investigate positive features of EHRs that can be leveraged to facilitate nurses’ satisfaction with the use of EHRs in nursing practice and investigate features of EHRs that exert a negative impact or create barriers to nurses’ satisfaction with use of EHRs in 11 nursing practice. Foundational work for this study began with a manuscript exploring nurses’ psychological adaptation to EHR usability through the lens of the Unified Theory of Acceptance and Use of Technology. A second manuscript provided a concept analysis of nurses’ psychological adaptation to electronic health record usability. The final phase was a secondary data analysis of Texas statewide studies conducted in 2015 and 2020 to explore nurses’ satisfaction with EHRs using a polarity model as an underpinning for the study. The secondary data analysis revealed that factors related to technology and practice had a statistically significant impact on nurses’ satisfaction and dissatisfaction with EHRs. When controlling for hospital and nurse factors, magnet status and computer skills had a statistically significant impact on nurses’ satisfaction and dissatisfaction with EHRs, with magnet status displaying the most significant impact.

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Dr. Susan McBride, Dr. Mari Tietze, Dr. Cheryl Parker, Dr. Huaxin Song


Nursing PhD

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