Nurses are not happy about having to use electronic health records (EHRs), a new report suggests.
According to the Q3 2014 Black Book EHR Loyalty survey, 92 percent of nursing staff are dissatisfied with the systems — an all-time high. The primary reasons cited for their dissatisfaction with EHRs included the levels of disruption in productivity and the impact to their daily workflows.
Nurses in 84 percent of U.S. hospitals also state they are struggling with flawed EHR systems, and as many as 88 percent blame financial administrators and CIOs for selecting low-performance systems because of low prices, the need to chase federal incentives and cutting corners at the expense of quality of care.
According to an overwhelming majority of nurses, the impact of the systems on nurses' workloads — including the efficient flow of direct patient care duties — was not considered highly enough in administration's final EHR selection decision.
The survey included responses from about 14,000 licensed registered nurses from 40 states who worked in hospitals that had an EHR for more than six months. Survey respondents also ranked the vendor performance of 19 inpatient EHR systems from a nursing satisfaction perspective, naming the best and worst systems.
"Although the inpatient EHR replacement frenzy has calmed temporarily, the frustration from nurse EHR users has increased exponentially," said Doug Brown, managing partner of Black Book Rankings, in a statement. "The meaningful use financial incentives for hospitals have many IT departments scurrying to implement these EHRs without consulting direct-care nurses, according to the majority of those polled by Black Book."
Additional insight extrapolated from the survey includes:
- 90 percent of EHR nurses said their current EHR system has negatively impacted communications between them and their patients.
- 94 percent of nurses don't believe their current EHR has improved communication between the nurse and the care team.
- Only 26 percent of nurses surveyed said their current EHR improves the quality of patient information.
However, when it comes time to addressing vulnerabilities in the systems, 30 percent of nurses believe their hospitals' IT departments respond quickly to making necessary changes. And 67 percent of nurses reported they have been taught workarounds to allow other members of their teams to view pertinent information related to a patient, as to not lower the quality of care and avoiding the EHR systems' flaws.
But, according to the survey, a lack of IT resources also impacts nursing productivity. In for-profit facilities, 93 percent of nurses said they do not have the computers to handle their appointed tasks in each room they work nor do they have handheld or mobile devices to aid them in the EHR assignments. Also, 91 percent of respondents in for-profit hospitals said they have difficulty locating an available mobile EHR workstation, which also takes time away from patient care.
Because of the trouble of EHRs, 79 percent of job-seeking registered nurses reported that the reputation of the hospital's EHR system is a top consideration in their choice of where they will work. Nurses even named the systems they like and those they don't.
The best EHRs are: Cerner, McKesson, NextGen and Epic Systems. The worst are: Meditech, Allscripts, eClinicalWorks and HCare.
Black Book's Brown also offered an assumption based on the survey's results: "Hospitals, particularly in competitive markets, will experience an exodus of nurses who will change employers for those with flexible, highly usable EHRs, where nurses feel they can get more real time to care of patients."
