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The Impact of Electronic Health Records on Nurses and Nursing Care in Low- and Middle-Income Countries: A Scoping
Wahab Osman1,2,3, Stephanie Asah-Ofori1, Alexandra Harris1,4,5
1Lawrence Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.
Aim:
To map evidence and identify research gaps from primary studies on the impact of electronic health records (EHRs) on nurses and nursing care in low- and middle-income countries (LMICs) from 2015 to 2024.
Design:
A scoping literature review.
Review Methods:
Guided by the Joanna Briggs Institute (JBI) guidelines for evidence synthesis, two reviewers conducted screening and data extraction using Covidence.
Data Sources:
A systematic search of Medline, Embase, CINAHL, Scopus, Web of Science, and WHO Global Index Medicus databases was conducted in May 2024.
Results:
Of 6122 studies, 41 were included. Most employed quantitative methods, but often did not use validated tools or theoretical frameworks. EHRs improved documentation, but some quality deficits remain. Depersonalized care, workflow disruptions, reduced nurse-patient interaction, and technostress were also reported. Regional research output disparities emerged.
Conclusions:
The evidence demonstrates that EHRs enhanced nursing documentation and data access, yet were also associated with data quality deficits, increased burden, workflow disruption, technostress, and depersonalized care in LMICs. The LMIC regional research disparities and theoretically underdeveloped evidence base, particularly from Sub-Saharan Africa, necessitate nurse-led investigations of documentation quality, workload, care disruption and nurse well-being to inform context-sensitive practice, education and policy.
Implication For Nursing And/Or Patient Care:
The findings will guide nurses and policymakers in this region to optimize the use of digital health systems, promote equitable access, stimulate further research, provide solutions, and support effective ehealth transformation in LMICs.
Impact:
This review identifies critical gaps in current research on electronic health records, highlighting both benefits and drawbacks for nurses and nursing care. The findings will guide nurses and policymakers in this region to improve digital systems implementation and inform future nursing research and policy development.
Reporting Method:
Reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR).
Patient Or Public Contribution:
No Patient or Public Contribution.
Review Protocol Registration:
DOI: https://doi.org/10.17605/osf.io/gntks.
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