Advanced Practice Nurses' Meaningful Use of Electronic Health Records

Monday, 22 July 2013: 10:45 AM

Thomas Kippenbrock, EdD, RN
School of Nursing, University of Arkansas, Fayetteville, AR

Learning Objective 1: The learner will be able to understand the expectation of the advanced practice nursesí meaningful application of electronic health record (EHR).

Learning Objective 2: The learner will be able to evaluate differences in advanced practice nursesí meaningful application of electronic health record (EHR).

Purpose: The electronic health record (EHR) is becoming an integral component of the U.S. health care system.  Federal law was enacted with specific provisions that offer incentive payments to eligible professionals and hospitals to use EHRs; however, little is known about APNs’ EHR use. The purpose of this study is to investigate differences in advanced practice nurses’ (APN) meaningful application of electronic health record (EHR) users from non-users.  EHR introduction into the health care system can be viewed as an innovation; as such it constitutes a revolutionary change in health care organization and in the practice setting.  Its adoption and diffusion are part of a complex process described by Rogers (2003), whereby getting a new technology adopted, even when it has obvious advantages, is difficult.  

Methods: A quantitative, non-experimental research method was used.  A random sampling of APNs employed in the U.S. southern region was selected.  An online survey was used to collect data about EHR use; 526 individuals responded to the survey.  To investigate the differences between APN EHR-users vs. non-users, a chi-square test for categorical variables was used and the nonparametric test of Mann-Whitney U Test for continuous variables.  To determine APNs’ socio-demographics and practice characteristics associated with the use of EHRs, a multivariate logistic regression was used.  An alpha level of 0.05 was used for all statistical tests. 

Results: The results were two thirds of the APNs were EHR-users; however, there were no statistically significant differences in meaningful use of EHRs (e.g. prescription refill, laboratory report, talking to pharmacist, and care transition) between APN users and non-users.

Conclusion: The conclusions are that one third of the APNs are EHR non-users.  Therefore, more information is needed to determine adapting EHR systems to their workflow and choosing systems that facilitate clinical usefulness.