Nurses' Electronic Medical Record Workarounds in Mental Healthcare Settings

This study aimed to examine nurses' EMR workarounds in mental healthcare settings. Of the 52 nurses invited to participate in this study, 50 nurses (96.1%) completed the survey using the EMR nursing workaround instrument and open-ended questions. The data collected were analyzed using descriptive statistics and Pearson's correlation coefficients. The descriptive data were grouped into four units including the cases, contributing causes, and consequences of EMR workarounds, and suggestions for improving EMR implementation. The results showed scores above an average of 3.0 in all of the EMR workaround items, indicating the considerable involvement of nurses in EMR workarounds. The workarounds related to EMR use were using the physician's login account for medication access, performing retrospective documentation, performing documentation before an expected busy situation, and seeking and entering information on external medications. The workarounds associated with colleagues unfamiliar with EMR use included waiting for, filling in for, teaching, and assisting unskilled colleagues. This study identified the problems, consequences, and suggestions associated with EMR implementation for psychiatric patient care. This study added useful information for the administrative, technical, and clinical improvement of EMR implementation in mental healthcare practice.