Attitudes of nursing staff towards electronic patient records: a questionnaire survey

A growing number of health care organizations are implementing a system of electronic patient records (EPR). This implies a change in work routines for nursing staff, but it could also be regarded as an opportunity to improve the quality of care.

The objective of this paper is to obtain more insight into the usefulness of EPR as perceived by nursing staff and to clarify the determinants of nursing staff's acceptance of EPR. Determinants were tested using an extended version of the Technology Acceptance Model.

Nursing staff members (NAs and RNs) completed a survey questionnaire about the use of EPR in health care, and their experiences, perceptions and attitudes regarding EPR.

All nursing staff members were working in Dutch hospitals, psychiatric organizations, care organizations for mentally retarded people, home care organizations, nursing homes or homes for the elderly.

The study population is a nationally representative Dutch research sample, further referred to as the Nursing Staff Panel. The Panel consists of a permanent group of Nursing Assistants (NAs) and Registered Nurses (RNs), who are prepared to fill in a postal questionnaire twice a year on average. In January 2009, 685 participants completed the questionnaire.

Nursing staff members associate EPR with improved care, especially qualitatively better and safer care. They also expect an increase in costs of care, while anticipating only a relatively small rise in the number of patients that can be cared for. In general, the effects of EPR on the work circumstances of nursing staff are expected to be negative. Job-related characteristics were found to be determinants of attitudes towards using EPR. A relatively positive attitude towards EPR was found in three categories of nursing staff in particular, i.e. staff working at least 30h per week, staff already using EPR and staff working in hospitals. Nursing staff in management positions also tend to have a more positive attitude. When the Technology Acceptance Model was tested, attitudes towards EPR were primarily associated with job-related characteristics and perceived usefulness with respect to quality of care.

The implementation strategies for EPR need to take account of the job characteristics of the intended future users. If implementation is to be successful, it is important that the users understand the beneficial effects of EPR on the quality of care.