Registered nurses' use of electronic health records: findings from a national survey.

OBJECTIVE: (1) To determine the proportion of the registered nurse (RN) workforce that uses a minimally functional electronic health record (EHR) system; (2) to assess the relationship between EHR use and beliefs about quality of care and quality improvement activities; and (3) to determine whether EHR use is associated with less time spent on paperwork and documentation and more time spent in direct patient care.
DESIGN: Data were collected through use of a 6-page survey mailed to a nationally representative sample of RNs. The study is cross-sectional and examines associations between EHR use and measures of quality and time spent on patient care-related tasks. MEASUREMENTS: A minimally functional EHR was defined as routine use of electronic patient demographics; electronic ordering of tests, procedures, or drugs; electronic clinical and patient notes; electronic access to test results; and electronic decision support. RNs were categorized into those employed in practices or hospitals where 0 functionalities were in routine use, 1 to 4 functionalities were in routine use, or 5 functionalities were in routine use.
RESULTS: Fewer than 1 in 5 RNs work in healthcare settings that have adopted a minimally functional EHR. Use was related to measures of nursing excellence and increased efforts at quality improvement. There were no differences between RNs using an EHR and those not using one on time spent in patient care-related tasks.
CONCLUSION: This study is the first to provide national data on RNs' use of EHRs. It suggests important relationships between EHR use, quality improvement, and nursing excellence.