Exploring the Electronic Health Record (EHR) as a Communication Channel that Influences the Workflow of the Nurse in Response to a Clinical Event

Abstract

The purpose of this qualitative descriptive research was to explore responding (RSRN) and receiving nurses’ (RCRN) perspectives on messages delivered from the EHR in response to a clinical event (CE). This study had two aims: 1) Explore nurses’ utilization of the EHR as a communication channel that provides patient data for the nurse to process and implement into workflow. 2) Explore nurses’ perspectives on their approach to processing EHR data in response to a CE. The EHR as an ineffective communication tool has been studied. However, little is known how the EHR functions as a communication channel for nurses to access, retrieve and process data and information for communication. Using Shannon’s Information Theory (1949), semi-structured interviews were constructed to explore nurses described perspective of screens accessed, data and information processed, strengths and limitations of current EHR, and recommendations for EHR improvement. Twenty medical-surgical nurses participated in a ZoomHealth recorded interview. The general inductive approach and content analysis were used to analyze verbatim transcripts and establish patterns and themes. Transcript segments were grouped into responding nurses (RSRN) or receiving nurses (RSRN) caring for a patient experiencing or post CE. Thirty-two thematic units were described by participants, among themes explored two major themes were identified by participants: time and process of data into information. Significant time is spent accessing and retrieving data and information from the EHR. After retrieval participants struggled to describe how data and information was organized into a usable form to implement into workflow. The role of the nurse changes how messages from the EHR are accessed, retrieved, and processed into information. Potential data and information processing models are proposed.