There are multiple trends that can be observed in modern nursing, and some of them pose unique and pressing challenges. One of such trends is the increased use of information health systems, which include Electronic Health Records (EHRs) (McLaughlin, 2017). EHRs can be very helpful to nurses, as well as other healthcare professionals, but they are not always implemented and used effectively (Barrett, 2018; Kruse, Kothman, Anerobi, & Abanaka, 2016). As a result, EHRs represent both a trend and a problem that nurses can help to resolve through leadership, research, and action.
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The use of information technology in healthcare is evidenced to be beneficial. Multiple studies demonstrate that EHR application in a variety of settings and contexts tends to result in improved processes (for example, enhanced efficiency), greater productivity, better communication, reduction in errors, and overall improvement of care (Jawhari, Ludwick, Keenan, Zakus, & Hayward, 2016; Kruse et al., 2016). As pointed out by Kruse et al. (2016), these benefits are sufficiently documented, which is why EHR integration into care is a requirement by now. However, EHR use is not just a trend that nursing specialists currently observe; it is also a challenge, which is constructed of multiple issues. Such issues can be united under the general concern of ineffective EHR use and implementation (Barrett, 2018). EHR integration is necessary for modern healthcare because EHRs yield noticeable benefits, which means that this problem needs to be addressed.
It is possible to classify the phenomena that influence the described problem into those related to change and policy, as well as individual factors. First, the effectiveness of the change effort associated with EHR implementation affects its integration and use. In addition, it incorporates multiple facilitators and barriers, which should be mentioned here. Change is difficult, and, as a result, change efforts need to be very well-designed. Generally, resources on change highlight the significance of planning, monitoring, and adjusting change as required while taking into account the particular difficulties and issues experienced by the people affected by the change (Spear, 2016). Another important factor is communication; poor communication of the information that is vital for change (from its vision and mission to more specific details) tends to have negative results and vice versa (Barrett, 2018). Thus, the way change is carried out is important for successful EHR integration and use.
Furthermore, resource availability prior to, during, and after the change is significant. Resources may include human or financial ones, as well as those related to the equipment available (Jawhari et al., 2016). In connection to human resource shortages, the training concerns are usually noted as well; the lack of training is a significant barrier to EHR-related change (Kruse et al., 2016). Basically, if healthcare organizations do not have the means of ensuring EHR integration, EHR is not going to be integrated.
Another very important consideration is provider concerns. As a result of the lack of training and awareness, as well as hesitation related to financial pressures, individual providers may find it difficult to move toward using EHRs (Kruse et al., 2016). Such concerns are not uncommon, and they have been shown to affect the effectiveness of change efforts. As a result, provider resistance is another phenomenon that affects the targeted problem.
Secondly, it should be mentioned that there are policy and regulation factors. For example, in the US, there exist particular mandates which are instituted to foster EHR use (Barrett, 2018; Kruse et al., 2016). Such mandates can result in financial penalties in cases of non-compliance. This factor provides incentives for the solution of the problem; in general, government and local policies can be viewed as a form of influence on EHR adoption and use. However, these regulations, while having an impact, are not always effective; for example, in the US, the compliance with HITECH Act requests has achieved only 55% by the year 2014 (Kruse et al., 2016). In other words, this factor is unlikely to force change and effective use without the consideration of the rest of the influences.
Finally, it is noteworthy that more specific factors have also been discovered. For instance, it appears that practitioners with greater experience have the tendency to be more resistant to EHR-related change (Barrett, 2018), which is an interesting observation. When preparing EHR change, the specialists who are responsible for it need to research the topic extensively and apply their knowledge to find a customized solution to their EHR challenge.
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Solutions to the Issue
The solutions to the challenge of EHR adoption are generally related to the factors which affect it. Given that relevant government policies already exist, they are not going to be considered in detail here. However, it can be noted that their slow effects may be connected to the fact that the rest of the associated factors may render them ineffective (Kruse et al., 2016). After all, regulations are not going to make much of an impact when providers cannot comply with them. Consequently, the solution to the presented problem requires complex interventions that address the above-discussed concerns.
A common approach to ensuring the effectiveness of change is the use of various change models. In general, they tend to provide advice that reflects the above-described problems. For example, the Kottler model, among other things, considers the significance of planning, addressing individual participant concerns, communicating crucial information, and monitoring the change (Spear, 2016). The choice of a particular model should depend on the needs of an individual unit that attempts to introduce or change its EHR.
Regarding some of the more specific problems studied that are dedicated to change, generally point out the importance of training (Fleiszer, Semenic, Ritchie, Richer, & Denis, 2016; McLaughlin, 2017). Given that EHR presupposes using information technology, training is especially significant for this problem; in addition, it can help to reduce provider resistance to the change (Kruse et al., 2016). As for individual concerns, the logical approach to their reduction consists of conducting investigations to determine their presence and potential solutions to them and introducing customized solutions. Among other specialists, nurses are capable of contributing to this kind of research.
The Role of Nurses
Nurses’ role in changes in healthcare institutions has always been prominent, and it remains significant for the changes related to EHR. Nurses are inevitably going to be involved in EHR adoption and use, which is why they have a direct impact on the effectiveness of both. Furthermore, nurses are leaders and change agents (Fleiszer et al., 2016; McLaughlin, 2017), and they can lead change efforts, promoting the introduction and improved use of EHR.
In addition, as practitioners, nurses are particularly likely to be familiar with local EHR issues within their medical institutions. As a result, they can be in the position to report problems and contribute to their reduction. Depending on the specifics of the pinpointed issue, it may require the attention of local management or various government bodies. Thus, nurses can affect the situation by promoting policy change.
Finally, nursing research involves, among other things, practice improvement (Boswell & Cannon, 2018; Fleiszer et al., 2016), and the advancement of EHR use is an appropriate topic for it. Through such research, as well as other investigations related to EHR, nurses can contribute to the development of new, better solutions to the problem. Examples can include new educational programs for different groups of EHR users or change models that are tailored specifically to assist EHR integration. In summary, nurses can develop and lead the above-mentioned solutions, as well as initiate them and contribute to them when required.
In summary, the introduction of EHR in healthcare settings is a nursing trend that has resulted in certain issues. Specifically, the effective and meaningful adoption of the technology proves to be difficult to achieve. The factors which determine the effectiveness of EHR adoption include those related to change efforts, as well as individual circumstances and political influences. The primary solution to the issue consists of well-developed change efforts; the specific decisions on the matter generally target particular factors that are of importance for EHR adoption and use. Nurses can initiate, lead, and contribute to such solutions, as well as research them and develop improved ones. As a result, it can be concluded that nurses play a major role in resolving the challenges of EHR and advancing this current healthcare and nursing trend.
Barrett, A. (2018). Electronic Health Record (EHR) organizational change: Explaining resistance through profession, organizational experience, and EHR communication quality. Health Communication, 33(4), 496-506. Web.
Boswell, C., & Cannon, S. (2018). Introduction to nursing research (5th ed.). New York, NY: Jones & Bartlett Learning.
Fleiszer, A., Semenic, S., Ritchie, J., Richer, M., & Denis, J. (2016). Nursing unit leaders’ influence on the long-term sustainability of evidence-based practice improvements. Journal of Nursing Management, 24(3), 309-318. Web.
Jawhari, B., Ludwick, D., Keenan, L., Zakus, D., & Hayward, R. (2016). Benefits and challenges of EMR implementations in low resource settings: A state-of-the-art review. BMC Medical Informatics and Decision Making, 16(1), 1-12. Web.
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Spear, M. (2016). How to facilitate change. Plastic Surgical Nursing, 36(2), 58-61. Web.