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Electronic Medical Records (EMR) and Nurses in Turkish Hospitals

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Abstract

Electronic medical records (EMR) are generally used by nurses in hospitals. However, studies investigating views on and evaluations of EMR by nurses are limited in Turkey and in other countries around the world. In this study, nurses’ views on EMR systems were investigated in terms of “Nursing care management”, “Order entry”, “Information Management”, “Information quality”, “Service quality”, “Impact of EMR system on clinical care”. The purpose of this study was to investigate the views/perceptions on EMR used by nurses working at hospital clinics in Turkey. The research questions were: (a) What are nurses’ perceptions on EMR? (b) Were there relationships among nurses’ perceptions on EMR? (c) Were there differences among nurses’ perceptions on EMR according to hospitals in Turkey. This study is composed of field research conducted using questionnaires. To prepare the data-measuring instrument, the literature on EMR was reviewed. A Likert scale type was used in this questionnaire. The study was planned and conducted on nurses working at inpatient care units at four Turkish hospitals. At the end of this study, the questionnaire had been conducted on 517 nurses. Total response rate is 66.70 %. We found that the Information quality of EMR, impact of EMR system on clinical care and service quality were high level. Information quality has the highest mean score. EMR system is an important system for nurses’ hospital has the highest mean score in this study. Nurses feel about impact of EMR system on clinical care that generally ‘EMR system’s usefulness’, ‘improving quality of information due to EMR system’, ‘improving quality of nurses’ work’, ‘improving quality of information due to EMR system’. All of the six subscales of EMR were positively correlated with each other. This study revealed that there are significant differences among the mean scores for six subscales according to the ownership of hospitals. EMR systems were not well integrated into their workflow. In addition, half of all respondents had not been trained in using EMR systems. This study will added to evaluation views and assessments of nurses about EMR literature. The results will assist in determining “Information quality”, “Service quality”, of EMR, and “Impact of EMR system on clinical for nurses in Turkish health system”. This survey suggests that nurses favor the use of an EMR and suggests opportunities for EMR enhancement.

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Acknowledgments

The authors are grateful to several anonymous reviewers for their very helpful comments.

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Correspondence to Mehmet Top.

Appendix 1

Appendix 1

An example questionnaire form

Items of the EMR system

1    2    3   4   5

To what extent do you use the EMR system for each of the following tasks?

 Nursing care management

1

5

Never/almost never/not at all

Always/almost always

  1. Reviewing the patients problems

  

  2. Entering daily nursing care notes

  

  3. Capturing patient observations at the bedside

  

  4. Writing nursing care plans

  

  5. Writing nurse care worksheets (Kardex)

  

  6. Collecting patients info for discharge reports

  

  7. Documenting physical assessment of patients

  

Frequency of use of order entry

  8. Obtaining information on investigation or treatment procedures

  

  9. Obtaining the results from new tests or investigations

  

  10. Answering questions concerning general medical knowledge (concerning treatment, symptoms, complications, etc.)

  

  11. Obtaining results of tests and investigations

  

  12. Checking drug information (such as allergy and interactions)

  

 Information management

  13. Seeking out specific information from patient records

  

  14. Produce data reviews for specific patient groups, e.g. complication rate, diagnoses, etc

  

  15. Giving written individual information to patients, e.g. about medications, disease status

  

In your hospital, to what extent

 Information quality

1

5

Not at all

Very great

  16. Degree of EMR system’providing the precise information you need

  

  17. Degree of EMR system’s meeting your information needs

  

  18. Degree of EMR systems’s provideing reports that seem to be just exactly what you need

  

  19. Degree of EMR system’s providing sufficient information

  

  20. Degree of EMR system’s accuracy

  

  21. Degree of satisfaction with the accuracy of EMR system

  

  22. Degree of thinking the output is presented in a useful format

  

  23. Degree of information clearance

  

  24. Degree of EMR system’s user-friendship

  

  25. Degree of getting the information you need in time

  

  26. Degree of EMR system’s provide up-to-date information

  

 Service quality

  27. Degree of counting on the system to be up and available

  

  28. Degree of EMR system’s problems and crashes

  

 Impact of EMR system on clinical care

  29. Degree of feeling EMR system’s usefulness

  

  30. Degree of improving nurses’ performance due to EMR system

  

  31. Degree of improving quality of nurses’ work

  

  32. Degree of feeling EMR is worth the time and effort required to use it

  

  33. Degree of feeling improving quality of information due to EMR system

  

  34. Degree of feeling EMR system has been successful in your hospital

  

  35. Degree of feeling EMR system is an important system for your hospital

  

  36. Degree of training in using EMR systems

  

  37. Degree of computer workstation’s deranging your workflow

  

  38. Degree of impeding of the lack of staff computer skills the use of EMR system

  

  39. Degree of workstations’ availability for use by nurses

  

  40. Degree of well integrating computerized documentation into the workflow

  

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Top, M., Yilmaz, A. & Gider, Ö. Electronic Medical Records (EMR) and Nurses in Turkish Hospitals. Syst Pract Action Res 26, 281–297 (2013). https://doi.org/10.1007/s11213-012-9251-y

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