Master of Arts in Nursing

USE OF ELECTRONIC HEALTH RECORD (EHR) AND QUALITY OF CARE

AMONG CRITICAL CARE NURSES IN PRINCE MOHAMMED
BIN ABDULAZIZ HOSPITAL

Submitted By:

AL-SAUDI A. LAKIBUL

MAN-DL, AY 2021-2022

Wesleyan University Cabanatuan City, Philippines

Thesis Writing

Dr. Wilfred C. Ramos

Advised

APRIL 2022

Chapter 1
 Introduction

Rationale

Electronic health record (EHR) is now widely used in most of the hospitals around the

globe. As part of digitalization our health care system also adapted EHR.  It gives us a tool which

can be used to help us cope with the complexity and efficiency which is often required in many

areas of work. This has put a great change specially in hospital critical care areas. Nurses

traditionally spent more time in attending patients’ needs bedside and using paper patient chart in

documentation and reviewing patient’s medical records. digital version of a patient’s paper chart

can affect the quality of patient care that a nurse gives.

EHRs are patient-centered, real-time records that make information available to authorized

users promptly and securely. While an EHR system does contain a patient's medical and

treatment history, it is designed to go beyond traditional clinical data collected in a provider's

office and can encompass a broader view of a patient's care. EHRs are important pieces of health

IT because they may store a patient's medical history, diagnoses, prescriptions, treatment plans,

immunization dates, allergies, radiological pictures, and lab and test results. It gives providers

access to evidence-based tools for making decisions about a patient's care. This can also help to

automate and streamline the workflow of providers (healthit,2019).

The EHR system has been progressively being adopted on a global scale in both developed

and developing countries due to its potential to provide healthcare services universally to its

inhabitants. Currently 58% of WHO member states have an e-health strategy. Likewise, it is

presumed that in the long term, accelerated innovations in the field of e-health will transform the

workflow in the field of healthcare. Also, the adoption of e-health technology can promote health
services, health surveillance, health-related literature and education in an easy and accessible

way.

In addition to helping the advancement of technologies, the EHR system promotes a change

in perspectives and attitudes towards people and strengthens the commitment to creating global

networks to improve local, regional and global health services. According to the Global

Observatory Health Survey, EHR technology tools are useful for most of the developed

countries. In fact, >70% of the countries are successfully using e-health services and developed

countries continue to invest in e-health systems and technologies to improve their quality of

healthcare.

There is an inadequate study about nurse’s satisfaction on the use of EHR and the the qualityof

care given in critical care areas in hospitals. The objective of this study is to assess the level of

satisfaction on the use of EHR in terms of functionality, software interfaces, overall ease and

flexibility. This study will also assess the quality of care given by the nurses to their critical

patient and correlate it with the level of EHR use satisfaction.

Literature Review

This section presents the review of related literature and studies that are all directed to the

accomplishments of the aims and purposes of this study. These literature and research works are

present to serve as bases in the interpretation of the data to be gathered. These studies either

support or refute the finding of some studies.

Electronic Health Record (EHR)

An Electronic Health Record (EHR) is a digital representation of a patient's medical history

that is maintained over time by the provider and may include all of the key administrative

clinical evidence relevant to that person's care under that provider, such as demographic trends,

clinical documentation, issues, medications, vital signs, medical histories, vaccinations,

laboratory results, and radiology reports. The electronic health record (EHR) streamlines the

clinician's workflow by automating access to information. Other care-related activities, such as

evidence-based decision support, quality monitoring, and outcomes reporting, can be supported

directly or indirectly by the EHR through various interfaces. EHRs are the next phase in

healthcare's evolution, and they have the potential to improve patient-clinician relationships.

Providers will be able to make better judgments and deliver better care as a result of the data, as

well as its timeliness and availability. By improving the quality and clarity of medical records,

the EHR can improve patient care by lowering the occurrence of medical errors. Making health

information more accessible, minimizing errors of investigations, lowering treatment delays, and

ensuring that patients are well-informed to make better decisions are all priorities. Improving the

quality and clarity of medical records to reduce medical errors, Medicare & Medicaid (2021)

Importance of EHR

EHRs can help with patient care in a variety of ways. They can help with diagnosis by

allowing clinicians access to all of a patient's health information, which gives practitioners a
more complete picture and allows them to diagnose problems faster. Furthermore, EHRs can aid

in the reduction of medical errors, the increase of patient safety, and the promoting of quality

results. While electronic health records (EHRs) store and transmit data, they also alter patient

data in a better way and offer that information to caregivers at the point of care. EHRs can also

help enhance health outcomes for patients by allowing providers to see the health information of

the entire patient population, recognize particular risk factors and improve outcomes. Every EHR

system comes with a set of standard and critical features. For starters, EHR platforms frequently

include a patient portal where patients may access information, as well as secure data sharing and

access from other healthcare companies. Patient care orders, such as medicine requests and

diagnostic test orders, are generally placed in EHRs for clinicians. EHRs can track medication

doses for specific patients and alert doctors to any potential drug interactions. Order sets,

outcomes, and patient consents and approval can all be managed by the systems. Furthermore,

electronic health record systems usually aid in the monitoring and scheduling of clinician

workflow. Finally, these programs aid in the completion of clinical, financial, and administrative

coding. This feature offers assistance with service requests and refund claims., healthit (2021).

Electronic Health Record (EHR) to keep track of their patients’ care, including their medical

and treatment histories. EHR systems give authorized medical professionals such as clinics and

their staff a broader view of patient overall health and wellness. Additionally, patient information

indicated on a patient’s EHR is transferable from one clinic to the next. Through EMR systems,

you would no longer need as many chart pulls as before. EMR systems in the Philippines

improve the coding of visits, and they are also an excellent way for you to give your patients
reminders. EMR systems house patients’ medical history, diagnoses, medication and treatment

plans, allergies, immunization dates, laboratory test results, and more. With an EMR software

from the Philippines at your aid, you have access to evidence-based tools and guidelines to

demonstrate high-quality healthcare. Automate and streamline your workflow for the best office

experience and customer satisfaction through EMR in the Philippines, LinkedIN(2021).

There is a study by Hewner et al. (2018) stated that efforts to improve care transitions

require coordination across the healthcare continuum and interventions that enhance

communication between acute and community settings. To improve post-discharge utilization

value using technology to identify high-risk individuals who might benefit from rapid nurse

outreach to assess social and behavioral determinants of health with the goal of reducing

inpatient and emergency department visits. The project employed a before and after comparison

of the intervention site with similar primary care practice sites using population-level Medicaid

claims data. The intervention targeted discharged persons with preexisting chronic disease and

delivered a care transition alert to a nurse care coordinator for immediate telephonic outreach.

The nurse assessed social determinants of health and incorporated problems into the EHR to

share across settings. The project evaluated health outcomes and the value of nursing care on

existing electronic claims data to compare utilization in the years before and during the

intervention using negative binomial regression to account for rare events such as inpatient visits.

Avoiding readmissions and emergency visits, and increasing timely outpatient visits improved

the individual's experience of care and the work life of healthcare providers, while reducing per

capita costs (Quadruple Aim). In the intervention practice, the nurse care coordinator
demonstrated the value of nursing care by reducing inpatient (25%) and emergency (35%) visits,

and increasing outpatient visits (27%). The estimated value of avoided encounters over the

secular Medicaid trend was $664 per adult with chronic disease, generating $71,289 in revenue

from additional outpatient visits.

There is a national focus on the adoption and use of electronic health records (EHRs) with

electronic prescribing (e-Rx) for the goal of providing safe and quality care. Although there is a

large body of literature on the benefits of adoption, there is also increasing evidence of the

unintentional consequences resulting from use. As little is known about how use of EHR with e-

Rx systems affects the roles and responsibilities of nurses, the purpose of this qualitative case

study was to describe how nurses adapt to using an EHR with e-Rx system in a rural ambulatory

care practice. Six themes emerged from the data. Findings revealed that nurses adjust their

routine in response to providers' preferential behavior about EHR with e-Rx systems yet retained

focus on the patient and care coordination. Although perceived as more efficient, EHR with e-Rx

adoption increased workload and introduced safety risks, Abbott et al. (2018).

The study conducted by Feder et al., (2018), revealed that as electronic health records

(EHRs) become more common, nurse scientists are becoming more interested in using EHR data

in a range of research methodologies. Nevertheless, when EHR data is used for nonclinical

purposes, methodological issues with data quality may occur. As a result, this article discusses

typical data quality fields and methods to quality assessment in EHR research. Data quality,

completeness, reliability, authenticity, and timeliness are all common data quality domains. Data

analysis with data rules, assessment and validations of data abstraction methods with statistical
studies, data correlations with manual chart review, management of missing data with statistical

methods, and discussion of the data between multiple EHR databases are some of the approaches

for quality appraisal. Quality data improve the validity and reliability of research outcomes,

serve as the foundation for data-driven findings, and are thus an important part of EHR-based

study concept and implementation.

Changes in the patient record from the paper to the electronic health record format present

challenges and opportunities for the nurse researcher. Current use of data from the electronic

health record is in a state of flux. Novel data analytic techniques and massive data sets provide

new opportunities for nursing science. Realization of a strong electronic data output future relies

on meeting challenges of system use and operability, data presentation, and privacy. Nurse

researchers need to rethink aspects of proposal development. Joining ongoing national efforts

aimed at creating usable data output is encouraged as a means to affect system design. Working

to address challenges and embrace opportunities will help grow the science in a way that answers

important patient care questions, Samuels et al.(2015).

Challenges on use of HER

According to study conducted by Richesson et al. (2014), the major challenges for the use of

EHR-derived data for research include the lack of standard methods for ensuring that data

quality, completeness, and provenance are sufficient to assess the appropriateness of its use for

research. Areas that need continued emphasis include methods for integrating data from

heterogeneous sources, guidelines (including explicit phenotype definitions) for using these data in both

pragmatic clinical trials and observational investigations, strong data governance to better understand and
control quality of enterprise data, and promotion of national standards for representing and using clinical

data.The use of EHR data has become a priority in CRI. Awareness of underlying clinical data collection

processes will be essential in order to leverage these data for clinical research and patient care, and will

require multi-disciplinary teams representing clinical research, informatics, and healthcare operations.

Considerations for the use of EHR data provide a starting point for practical applications and a CRI

research agenda, which will be facilitated by CRI's key role in the infrastructure of a learning healthcare

system.

Electronic health records (EHRs) documentation and navigation is a necessary, but difficult,

job. At a tertiary eye hospital in Saudi Arabia, we discuss the magnitude, sources, and measures

provided by nurses to alleviate EHR-related stress (EHR-S). Methods: In 2019, nurses from an

eye hospital were polled regarding EHR-S. A Likert scale was utilized to evaluate the answers to

ten different aspects of EHR-related tasks. The total score was graded as follows: minimum (<-

10), mild (<0 to -10), moderate (1-10), and severe (>11). Determinants were linked to the score.

Nurses' stress-reduction suggestions were examined over. Results: This survey covered 212

nurses. Of them, 106 (50%; 95% confidence interval: 43.3-56.7) reported EHR-S. The median

EHR-S score was -3.0 (interquartile range: -9.0; +8.0). Thirty-five (16%) nurses reported severe

EHR-S. Senior nurses (M-W, p < 0.02) and those working in emergency and recovery units (M-

W, p < 0.01) had statistically higher EHR-S. The main stressors were incomplete EHR work by

other departments affecting nursing care (70.8%), difficulty in correction after entering the data

(60.4%), and difficulty in data retrieval (60.4%). The main solutions to reduce EHR-S were to

reduce the frequency of changes to configuration of the EHR (58%), more training (54.2%), and

appreciation of good work (52.8%). Conclusions: EHR-S affects 50% of the nurses who work in
an eye care facility. Nurses' stress levels could be reduced by implementing solutions such as

greater training and fewer modifications to the EHR system., AlQahtani et al. (2021).

Rutten et al. (2020) studied the prevalence of inadequate symptom control among cancer

patients is quite high despite the availability of definitive care guidelines and accurate and

efficient assessment tools. They conduct a hybrid type 2 stepped wedge pragmatic cluster

randomized clinical trial to evaluate a guideline-informed enhanced, electronic health record

(EHR)-facilitated cancer symptom control (E2C2) care model. Teams of clinicians at five

hospitals that care for patients with various cancers will be randomly assigned in steps to the

E2C2 intervention. The E2C2 intervention will have two levels of care: level 1 will offer low-

touch, automated self-management support for patients reporting moderate sleep disturbance,

pain, anxiety, depression, and energy deficit symptoms or limitations in physical function (or

both). Level 2 will offer nurse-managed collaborative care for patients reporting more intense

(severe) symptoms or functional limitations (or both). By surveying and interviewing clinical

staff, we will also evaluate whether the use of a multifaceted, evidence-based implementation

strategy to support adoption and use of the E2C2 technologies improves patient and clinical

outcomes. Finally, we will conduct a mixed methods evaluation to identify disparities in the

adoption and implementation of the E2C2 intervention among elderly and rural-dwelling patients

with cancer. The E2C2 intervention offers a pragmatic, scalable approach to delivering

guideline-based symptom and function management for cancer patients. Since discrete EHR-

imbedded algorithms drive defining aspects of the intervention, the approach can be efficiently

disseminated and updated by specifying and modifying these centralized EHR algorithms.
Theoretical Framework

This study was grounded to the theory of Sister Callista L. Roy, The Adaptation Model of

Nursing (1976).

Sister Callista Roy designed the Adaptation Model of Nursing in 1976. After working with

Dorothy E. Johnson, Roy became convinced of the importance of describing the nature of

nursing as a service to society. This prompted her to begin developing her model with the goal of

nursing being to promote adaptation. She first began organizing her theory of nursing as she

developed course curriculum for nursing students at Mount St. Mary’s College. She introduced

her ideas as a basis for an integrated nursing curriculum.

Roy explained that adaptation occurs when people respond positively to environmental changes,

and it is the process and outcome of individuals and groups who use conscious awareness, self-

reflection, and choice to create human and environmental integration.

The key concepts of Roy’s Adaptation Model are made up of four components: person,

health, environment, and nursing. According to Roy’s model, a person is a bio-psycho-social

being in constant interaction with a changing environment. He or she uses innate and acquired

mechanisms to adapt. Individuals, as well as groups such as families, organizations, and

communities, are included in the model. This includes the entire society.
 The Adaptation Model states that health is an inevitable dimension of a person’s life, and is

represented by a health-illness continuum. Health is also described as a state and process of

being and becoming integrated and whole. The environment has three components: focal, which

is internal or external and immediately confronts the person; contextual, which is all stimuli

present in the situation that all contribute to the effect of the focal stimulus; and residual, whose

effects in the current situation are unclear. All conditions, circumstances, and influences

surrounding and affecting the development and behavior of people and groups with particular

consideration of mutuality of person and earth resources, including focal, contextual, and

residual stimuli.

The model includes two subsystems, as well. The cognator subsystem is a major coping

process involving four cognitive-emotive channels: perceptual and information processing,

learning, judgment, and emotion. The regulator subsystem is a basic type of adaptive process that

responds automatically through neural, chemical, and endocrine coping channels, Nursing

Theory.(2020).
 This theory will be applied to this study as electronic health record in a new technology in

health care. Nurses are able to adapt different changes. The way of giving quality patient care

should be there despite of new challenges that health care providers like nurses are facing.

Conceptual Framework

The diagram below shows the relationship between the independent variable and dependent

variable. The independent variables are the socio-demographic profile of the respondents and the

use of EHR Satisfaction. The dependent variables is the quality of patient care of the

respondents. The relationship of the independent and dependent variables will also be studied.
Figure 1: Schematic Diagram of Conceptual framework

Statement of the Problem

This study aims to know the use electronic health record and quality of care among critical

care nurses. Specifically, this study will seek to answers the following questions:

1.How may the socio-demographic profile of the respondents be described in terms of:

1.1 Age;

1.2 Sex;

1.3 Years of service;

 1.4 Monthly Income;

1.5 Area of assignment

2.What is the level of EHR use satisfaction of the respondents in terms of:

2.1functionality;

2.2. software interfaces;

2.3overall ease and flexibility?

3.What is the level of quality of the care that the respondents give to their patients?

4.Is there a significant relationship between socio-demographic profile and the level of quality of

the care that the respondents give to their patients?

5.Is there a significant relationship between the level of EHR use satisfaction and the level of

quality of the care that the respondents give to their patients?

Null Hypothesis:

To draw inferences from the study, the following hypothesis were tested at 0.05 level of

significance.

1. There is a no significant relationship between socio-demographic profile and quality patient

care of the respondents.

2. There is a no significant relationship between the level of EHR use satisfaction and quality

patient care of the respondents?

Definition of Terms

To show better comprehension of the study, the following key terms are defined

operationally, how they words are used in the study.

Critical Care Nurses In this study it refers to nurses assigned in Intensive Care Unit (neonatal,

pediatric and adult, ICU stepdown), Cardiac Care Unit, Labor and Deliver, Hemodialysis Unit,

Emergency Room and Operating Room. Nurses assigned in ward and outpatient department

don’t belong to critical care nurses.

EHR Satisfaction This refers to the state of contentment of the nurses in the use of EHR during

their work.

Electronic Health Record In this study it refers to the electronic system used in critical area

specifically in terms of its functionality, software interfaces and overall ease and flexibility.

Quality of care This refers to the kind of care that the nurses in critical care render to their

patient. This will be based on the own perception of the nurses not on the rating of the patient.

Chapter 2

METHODOLOGY

Research Design

The researcher will employ descriptive-correlation design in describing, analyzing, and

interpreting data of EHR satisfaction and quality of patient care. The term “descriptive statistics”

refers to the analysis, summary, and presentation of findings related to a data set derived from a

sample or entire population (Corporate Finance Institute, 2021). Descriptive statistics is the term

given to the analysis of data that helps describe, show or summarize data in a meaningful way
such that, for example, patterns might emerge from the data. Descriptive statistics allow a

researcher to portray data in a more comprehensible way, allowing for easier interrogation. As a

result, descriptive statistics allows the researcher to present data in a more meaningful way,

making data interpretation easier (Siedlecki, 2020). Correlation, on the other hand, shows the

strength of a relationship between two variables and is expressed numerically by the correlation

coefficient. It measures the degree to which two securities move in relation to each other

(Investopedia, 2021).

Research Locale

This study will be conducted in Prince Mohammed bin Abdulaziz Hospital. The following

critical areas will be focused in this study, Intensive care unit, cardiac care unit, emergency

room, operating room, pediatric ICU, neonatal ICU and labor and DeliveryThere will be 100

nurse respondents that will be surveyed that are currently working in the areas.

Sampling Procedure

There are total of 45 staff nurses that are working in each critical areas in Prince

Mohammed bin Abdulaziz Hospital. There are total of 315 nurses if all critical areas will be

combined. Simple Random sampling techniques will be used in selecting the 174-sample

population using the Rao soft formula. The margin or error is 5% with 95 confidence level.

Simple random Sampling will be used to select respondents of the study. Random Sampling

refers to a variety of selection techniques in which sample members are selected by chance but

with the known probability of the selection. Inclusion criteria are the following: 1. Nurses must
work for at least two years in the critical area, 2. Nurses must be willing to participate in the

study, 3. Nurses must be not regularly floated or assigned in the mentioned critical areas.

Exclusion criteria in selecting respondents are, 1. Nurses that are in managerial position, 2.

Nurses that are not assigned regularly in direct patient care.

Scope and Delimitation:

This study main objective is to assess the level of satisfaction of nurses in the use of EHR

and to assess the quality of patient care that they give to their client based on the nurse

perspective not on the patient side. The level of HER satisfaction use will be correlated to the

quality of patient care they rendered. This study is limited only for 2 months for conducting the

actual survey. Only the data generated in the survey questionnaire will be assessed.

Research Instrument

The researcher will use survey questionnaire that composed of three parts.

First part of the questionnaire will be the sociodemographic profile of the respondents in

terms of their age Age, Sex, Years of service, Monthly Income and Area of assignment. This is a

self-made part of the instrument.

The second part of the instrument is a modified research questionnaire from Family

Practice Management web site, that will assess the level of EHR use satisfaction of the

respondents. Three areas will be assessed which are the functionality, software interfaces and

overall ease and flexibility.

 The third part of the questionnaire is the self-assessment of the nurse on the quality of

patient care that is rendered.

Data Gathering Procedure:

The researcher will ask permission from the hospital administration to conduct a study in

the specific areas in the hospitals. List of staff will be obtained in the human resource office and

sample participants will be selected through simple random sampling,

Selected participants will receive email or personal survey form and this will be collected during

or the day after distribution of the questionnaire.

Data Analysis

The researcher will carefully analyze the data that will be gathered. The researcher will use

Simple Frequency Counting, Percentage and Ranking, Weighted Mean and Pearson r in

analyzing the data. The data that will be gathered will be presented in a table and figures.

Simple percentage is used to determine the profile of the respondents. The data was

analyzed using the formula:

Percentage (%) = f/N X 100

Where;

F= is the frequency of the response,

N= is the total number of respondents,

 100= is constant to do away with decimal points in the value.

P= Percentage

Weighted mean was used to determine the rank of the reasons for the choice made by the

respondents.

Formula:
n

∑ ❑fi(xi)
i=1
Wm=
N
Where;
Wm= weighted mean
∑= Frequency
Xi= Score points
N= Number of respondents
To get the weighted range: (4-1) 0.75
4

Table 1. The verbal interpretation of the weighted mean:

Score Points Verbal Interpretation Mean Range
1 Always 1.00-1.75
2 Often 1.76-2.50
3 Rarely 2.51-3.25
4 Never 3.26-4.00

Pearson Chi-square Test. This is a statistical tool that is commonly used for testing
relationships between categorical variables.
Formula:
❑ 2
( f 0−f e )
x 2= ∑ ❑
❑ fe
Where:
 fo = the observed frequency
fe = the expected frequency if NO relationship existed between the variables

ETHICAL CONSIDERATION
An informed consent will be given to all participants which will be attached to the survey
questionnaire. Assurance will be given to the subjects that anonymity of each individual would
be maintained, and they are free to withdraw from the study at any time. Any information about
the respondents that is obtained as a result of the participation in this research will be kept as
confidential as legally possible. Respondent will also be protected from any harm. Respondents
in the study were informed about the procedure and purpose of the study and confidentiality of
information provided. Consent of all participants will be obtained as part of the study. All data
will be collected anonymously.

References:
Abbott, A. A., Fuji, K. T., & Galt, K. A. (2015). A Qualitative Case Study Exploring Nurse
Engagement With Electronic Health Records and E-Prescribing. Western journal of nursing
research, 37(7), 935–951.

Alice Petiprin, 2020, accessed March 16,

2022<https://nursing-theory.org/nursing-theorists/Sister-Callista-Roy.php>

AlQahtani, M., AlShaibani, W., AlAmri, E., Edward, D., & Khandekar, R. (2021). Electronic
Health Record-Related Stress Among Nurses: Determinants and Solutions. Telemedicine journal
and e-health: the official journal of the American Telemedicine Association, 27(5), 544–550.

Feder S. L. (2018). Data Quality in Electronic Health Records Research: Quality Domains and
Assessment Methods. Western journal of nursing research, 40(5), 753–766.
Finney Rutten, L. J., Ruddy, K. J., Chlan, L. L., Griffin, J. M., Herrin, J., Leppin, A. L.,
Pachman, D. R., Ridgeway, J. L., Rahman, P. A., Storlie, C. B., Wilson, P. M.,
& Cheville, A. L. (2020). Pragmatic cluster randomized trial to evaluate effectiveness
and implementation of enhanced EHR-facilitated cancer symptom control
(E2C2). Trials, 21(1), 480.

Hewner, S., Sullivan, S. S., & Yu, G. (2018). Reducing Emergency Room Visits and In-
Hospitalizations by Implementing Best Practice for Transitional Care Using Innovative
Technology and Big Data. Worldviews on evidence-based nursing, 15(3), 170–177.

Kristen Lee,2021, HealthIT, accessed March 16,

2022<https://searchhealthit.techtarget.com/definition/electronic-health-rec ord-EHR>

Medicare and Medicais, accessed March 16,

2022<https://www.cms.gov/Medicare/E-Health/EHealthRecords>

Richesson, R. L., Horvath, M. M., & Rusincovitch, S. A. (2014). Clinical research informatics
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amidst-covid-19-pandemic>

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 Master of Arts in Nursing

PART 1: SOCIO- DEMOGRAPHIC PROFILE

A. Age as of last birthday:_________

B. Sex
o Male
o Female

C. Years of service:_________
D. Monthly Income

o Below 4,000 riyals

o 4,001 – 6,000 riyals
o 6,001 – 8,000 riyals
o 8,001 above
 E. Area of assignment

o Intensive care unit

o ICU- Stepdown
o Cardiac care unit
o Emergency room
o Operating room
o Pediatric ICU
o Neonatal ICU
o Labor and Delivery
o Hemodialysis Unit

PART 2: LEVEL OF ELECTRONIC HEALTH RECORD SATISFACTION

Scale for the level of satisfaction

Scale Interpretation Verbal Description

4 Very Highly Satisfied The provision is observed 76-100% of the time

3 Highly Satisfied The provision is observed 51-75% of the time

2 Less Satisfied The provision is observed 26-50% of the time

1 Least Satisfied The provision is observed 0-25% of the time

FUNCTIONALITY 1 2 3 4

How satisfied are you with the way your EHR

allows you to perform the following :
1) Obtain and review lab and radiology results
2) Review and document progress and vital
signsnotes
3) Review data in flowchart form on demand
(e.g. vital signs, lipids, growth curves)
4) Review chart information (overall)
5) Create notes using only “point and click
technology” (no typing, transcription or voice
recognition)
6) Create and maintain medication lists
7) Document patient care (overall)
8) Track preventive care (overall) e.g. Identify
allergies
9) Manage referrals (overall)
10) Communicate electronically with office staff
regarding patient management
11)Provide patient education (overall)
12)Find patients with certain characteristics (e.g.,
all patients on a recalled drug)
13)Work without paper

SOFTWARE INTERFACES 1 2 3 4
For each software interface (electronic interface)
between your EHR and another system, how
satisfied are you with the way the interface
works?
14)Interface not present Practice management
system
15)Laboratory system
16)Radiology system
17)Commercial pharmacies (e.g., SureScripts
software)
18)Hospital information system

OVERALL EASE AND FLEXIBILITY 1 2 3 4

19)This EHR allows individual user-specific
customization.
20)This EHR minimizes user data input.
21)This EHR offers multiple note creation
options.
22)This EHR is fast (minimal wait between
screens, minimal boot-up time, etc.).

PART 3: LEVEL OF QUALITY PATIENT CARE

Scale for the level of quality patient care as perceived by the nurse

Scale Interpretation Verbal Description

4 Excellent The level is highest at 76-100%.

3 Very Good The level is high at 51-75%.

2 Fair The level is low at 26-50%.

1 Poor The level is lowest at 0-25%

LEVEL OF QUALITY PATIENT CARE 1 2 3 4

Based on your own perception as nurse,
rate the quality of patient care received
1. I organize my full patient assignment
appropriate to my clinical area
2. I am administering medications in a timely
manner
3. I address the needs of the whole patient,
not just the necessary tasks to be completed
4. I am managing all required aspects of
intravenous therapy, including insertion, site
assessment, bag changes, medication
administration, total parenteral nutrition,
central line management, and peripheral site
removal
5.I can differentiate between important patient
information and noncritical information for
patient management
6.I am prepared to provide physicians with
information about their patients to assist with
care decision-making
7.I have the ability to react appropriately in an
emergency situation
8.I have the ability to manage technical
aspects of patient care
9.I communicate clearly to ensure patient
safety (using such as repeat back and ISBAR)
10.I can prevent possible patient safety
incidents in nursing care
11.I can identify possible patient safety
incidence

THANK YOU FOR YOUR PARTICIPATION!