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Survey Research

In April 2010, AFT Healthcare sponsored a national survey on health information technology. The survey, conducted by Peter Hart and Associates, asked 604 hospital nurses whose facilities had switched to electronic health records to tell us what they thought about the change and found very mixed views.

The survey found that half—49 percent—of the surveyed nurses said their electronic systems have had a positive effect on the overall quality of patient care, while a nearly equal number—47 percent—said they have had a negative effect (23 percent) or no real effect (24 percent). When compared with "the old days" of using paper records, 27 percent of nurses said patient care and safety is better since the implementation of computerized records, 25 percent said it is worse, and 39 percent said it is about the same.

Regardless of their views on the impact of the computerized systems, there was widespread agreement on what is needed for the transition to a new system. Nearly all—93 percent—of the nurses surveyed said that it is important to have additional staff during the transition to make sure patients receive safe care, 84 percent said it's important for nurses to be involved in selecting the hardware and software for the new system, and 85 percent said every unit should include someone with clinical and information technology training for a smooth transition.

Highlights of the survey

  • 49 percent of nurses said new computerized systems have had a positive effect on patient care.
  • 70 percent said the systems have reduced medication errors, 60 percent said they have had a positive effect on patient safety, and 58 percent said they have helped in the coordination of care.
  • 23 percent of nurses said new computerized systems have had a negative effect on patient care, and 24 percent said they have not had any effect.
  • While they see computerized systems improving some aspects of care, pluralities of nurses also say that these systems have had a negative effect on stress levels (49 percent) and morale (37 percent).
  • 50 percent of the nurses said the computerized systems have had a negative effect on the amount of time needed to chart patient information, while 38 percent said they have had a positive effect, and 12 percent said they have had no real effect.
  • Nurses were evenly split on whether the systems reduced the amount of time spent on paperwork—38 percent said they have had a positive effect, 38 percent said they have had a negative effect, and 22 percent said they have had no real effect.
  • While 73 percent said implementation of the systems went smoothly, many problems were identified, including 52 percent who said physicians are refusing to use the new systems.
  • Nurses who reported a higher level of frontline staff involvement in implementation were more likely to report a positive impact on patient care.

Recommendations

  • Nurses widely agreed that each of the following would be extremely or very important for computerized systems to improve patient care:
  • Additional clinical staff should be present during training and when the system "goes live," to help with the patient load and ensure safe patient care.
  • Training and support should continue to be available for a considerable period of time after the system has been activated.
  • A clear explanation should be provided for how the new system will affect patient care.
  • Every unit should include someone with both clinical and information technology training to help nurses understand the new system.
  • Representatives from all professions that will use the new system should be involved in selecting the hardware and software, and in planning the training and activation.

You may be interested in surveying your colleagues on their experience with health information technology. A sample survey is included in the "Resources" box above.