Nurse motivation, engagement and well-being before an electronic medical record system implementation: A mixed methods study
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Rebecca M. Jedwab, email: rebecca.jedwab@monashhealth.org (1,2); Alison M. Hutchinson (3); Elizabeth Manias (2); Rafael A. Calvo (4); Naomi Dobroff (1,2); Nicholas Glozier (5); and Bernice Redley (3) - (1) Monash Medical Centre Clayton, Monash Health Digital Health Division, Nursing and Midwifery Informatics, Melbourne, VIC 3168, Australia (2) Faculty of Health, School of Nursing and Midwifery, Melbourne Burwood Campus, Deakin University, Melbourne, VIC 3125, Australia; (3) Centre for Quality and Patient Safety Research—Monash Health Partnership, Deakin University, Melbourne, VIC 3168, Australia; (4) Dyson School of Design Engineering, Imperial College London, South Kensington, London SW7 2DB, UK; and (5) Central Clinical School, Faculty of Medicine and Health, Sydney School of Medicine, The University of Sydney, Sydney, NSW 2050, Australia * Author to whom correspondence should be addressed
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- Monash Medical Centre, Melbourne, Victoria, Australia
Implementation of an electronic medical record (EMR) is a significant workplace event for nurses in hospitals. Understanding nurses’ key concerns can inform EMR implementation and ongoing optimization strategies to increase the likelihood of nurses remaining in the nursing workforce. This concurrent mixed-methods study included surveys from 540 nurses (response rate 15.5%), and interviews with 63 nurses to examine their perceptions of using a new EMR prior to implementation at a single healthcare organization. Survey findings revealed 32.2% (n = 174) of nurses reported low well-being scores and 28.7% (n = 155) were experiencing burnout symptoms. In contrast, 40.3% (n = 216) of nurses reported high work satisfaction, 62.3% (n = 334) had high intentions of staying in their role, and 34.3% (n = 185) were engaged in their work. Nearly half (n = 250, 46.3%) reported intrinsic motivation towards EMR use. Thematic analysis of focus group interviews revealed two themes, each with three sub-themes: (1) Us and Them, detailed the juxtaposition between nurses’ professional role and anticipated changes imposed on them and their work with the EMR implementation; and (2) Stuck in the middle, revealed nurses’ expectations and anticipations about how the EMR may affect the quality of nurse-patient relationships. In conclusion, anticipation of the EMR implementation emerged as a stressor for nursing staff, with some groups of nurses particularly vulnerable to negative consequences to their well-being.
The authors gratefully thank all participants and acknowledge support given by Michael Leiter (M.L.), Helen Rawson and Cheyne Chalmers as members of the project team, and Emilio Pozo and Katrina Nankervis. R.M.J. is a recipient of an Australian Government Research Training Program Scholarship through Deakin University’s Institute for Health Transformation and has received a research grant from the Nurses Board of Victoria Legacy Limited and an Australian Nurses Memorial Centre Australian Legion of Ex-Servicemen and Women Scholarship to support this PhD project.
This work appears in the Sigma Repository pursuant to a Creative Commons Attribution 4.0 International License attached to the work upon its publication in the journal acknowledged in this record. Please refer to the attached license (the icon at the bottom of this entry) for further information and terms. All terms of the license have been followed. The Sigma Repository is sharing this article for educational purposes only. There are no changes in this article from the original posting.
| Type | Article |
| Acquisition | Indexed from External Source (Per Creative Commons License) |
| Review Type | External Review: Previously Published Material |
| Format | Text-based Document |
| Evidence Level | Other |
| Research Approach | Mixed/Multi Method Research |
| Keywords | Nursing Workforce; Electronic Medical Record; Motivation; Work Engagement; Well-being; Burnout; Health Communication |
| Publisher | International Journal of Environmental Research and Public Health, 18(5), 2726. |
| Date | 2021-03-08 |
| Version | Publisher’s Version |
| DOI | https://doi.org/10.3390/ijerph18052726 |
| ISSN | 1660-4601 |
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