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A Mixed Methods Study Exploring Nurse-Patient Interactions in Acute Hospital Settings When Electronic Health Record

Carol Forde-Johnston^1,2, Dan Butcher¹, Ginny Mounce¹

¹Oxford School of Nursing and Midwifery, Oxford Brookes University, Oxford, UK.

Journal of Advanced Nursing

|July 7, 2026

Summary

Electronic Health Records (EHRs) can limit nurse-patient communication, creating task-oriented interactions. Improving EHR design and nurse training is crucial for quality patient care.

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Area of Science:

Nursing Informatics
Health Services Research
Human-Computer Interaction

Background:

The integration of Electronic Health Records (EHRs) into acute care settings aims to improve efficiency and patient outcomes.
However, the impact of EHR use on the quality of nurse-patient interactions remains a critical area for investigation.

Purpose of the Study:

To describe the quality of nurse-patient interactions during the use of Electronic Health Record systems in four acute hospital wards.

Main Methods:

An explanatory sequential mixed methods study involving 16 researcher observations using the Quality of Interactions Schedule tool.
Observations were followed by 16 nurse and 16 patient interviews.
Data were analyzed using descriptive statistics and thematic analysis, with integrated meta-themes.

Main Results:

Three meta-themes emerged: limited social and reciprocal communication, EHR systems impeding face-to-face interaction, and EHR scripts fostering task-oriented communication.
Cumbersome computer systems consumed nurses' time and attention, hindering direct patient engagement.
Nurses' reliance on EHR scripts shifted focus from patient-centered care to task completion.

Conclusions:

Healthcare stakeholders must address the unintended negative impacts of EHRs on nurse-patient interactions.
Nurses and educators should develop strategies to promote person-centered communication alongside EHR use.
Future EHR development requires collaboration with nurses to create less obtrusive and more user-friendly systems.