A cross-sectional multilevel study on nurses' experiences with health information systems: A key to understanding...

Objective: This study aimed to investigate how nurses' backgrounds, documentation skills, and experiences with documentation practices and information systems usage influence documentation hazards and to determine whether these hazards are linked to technology-induced errors (TIEs). Methods: An online survey was conducted to collect data from 3065 registered nurses working in Finnish hospitals and in acute, primary, and home care services regarding their experiences with electronic health records (EHRs) or client information systems (CIS). The data were analysed using linear and logistic multilevel models to identify patterns and correlations. Results: User interaction with EHR/CIS systems significantly influenced documentation hazards across different work environments. Perceived system-provided documentation support and documentation hazards were identified as contributors to TIEs. Conclusions: Improving system design and documentation support is a desirable goal, but it is not sufficient to mitigate documentation hazards and promote efficient practices. To achieve the best possible results, skilled users are needed to operate these systems.