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Usability of the Electronic Health Record with an Undergraduate Student Population

Usability of the Electronic Health Record with an Undergraduate Student Population. Stephanie Jones, RN, PhD Student Arthur Labatt School of Nursing University of Western Ontario Lorie Donelle , RN, PhD Arthur Labatt School of Nursing University of Western Ontario. Outline.

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Usability of the Electronic Health Record with an Undergraduate Student Population

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  1. Usability of the Electronic Health Record with an Undergraduate Student Population Stephanie Jones, RN, PhD Student Arthur LabattSchool of Nursing University of Western Ontario Lorie Donelle, RN, PhD Arthur Labatt School of Nursing University of Western Ontario

  2. Outline • Background and Significance • Methods Used • Data Collection • Data Analysis • Results • Conclusions and Implications for Practice • Questions??

  3. Background • Electronic Health Record (EHR) for all Canadians by 2015. • Best practices for collection, storage, and retrieval of patient health information. • Evidence based quality health care. • Enhanced efficiencies in the provision of care (Canada Health Infoway, 2008).

  4. Background • The EHR: • An electronic computer interface of patient health information or data that has been stored within multiple electronic databases or registries. • 3 types of electronic records: • EMR • PHR • EHR (Green & Thomas, 2008 ;Houston, 2008; Kupchunas, 2007; Leonard, Casselman, Wilijer, 2008; Terry et al., 2008).

  5. Background • EHR intended to: • Enhance communication among health care professionals (Carayon et al.,2009). • Provide practitioners with decision support systems. • Provide solutions intended to empower patients to manage their own self care (Canadian Health Infoway, 2008; Kupchunas, 2007).

  6. Significance • Imminence (MOHLTC, 2008). • Improved Health Outcomes (Scott-Cawiezell et al., 2009) . • Educational Preparation (Connors et al., 2002; Fetter, 2008; Kennedy et al., 2007).

  7. Purpose of Study • Explore undergraduate nursing students’ use of the EHR for patient care. • Specifically: • Nursing student usability issues in providing patient care associated with an electronic health record • Identifying appropriate content relevant to the creation of a nursing informatics curriculum.

  8. Methods • Mixed Method Design • Target Population • Sampling Strategy: • Convenience Sample • Advertisement in Class • Email

  9. Methods • Design: • OSCAR • Open Source System • Fictional Case Scenario • Usability Analysis • Morae usability software

  10. MethodsData Collection

  11. Methods • Data Analysis: • Transcribed Verbatim • Content analysis • Graphical Output

  12. Results • Participants • Female • Age Range: 22-29 • Previous Educational Experience

  13. Results • Six Themes: • (1) Being Novice • (2) Hide and Seek • (3) Trial and Error • (4) Labelling • (5) Confidentiality and Security • (6) Repetition and Practice

  14. Results • Being Novice • Novice Users’ • “Um, this particular one, uh cause this is my first time using it. Anything like you use more you feel more comfortable” • “Again, maybe just um, an issue of my lack of knowledge, I wasn’t necessarily sure what to put into ongoing concerns in the progress note, again, that is not necessarily a navigation issue, I think that’s really just a user error”.

  15. Results • Being Novice • Novice Practitioners • “...problems I had (pause) stemmed from my lack of knowledge (pause) as to where to chart (pause) specific things... I think in even terms of the fact that I’m still only a student, I haven’t chart a lot, I’ve never charted electronically. Um, I’m still not sure kinda what goes where” • “I don’t know what I’m going to say, I’m not very good at charting (laugh)... I’m not following any normal care plan, like form, I’m just putting her information in, just using the right spots to do it”

  16. Results • Confidentiality and Security • “So, there is a lot of tabs that came up, and logging out of the main screen didn’t actually log me out of those ones, so in terms of confidentiality, I need to make sure I close all of those things”

  17. Results • Repetition and Practice • “I think it’s just one of those things where it comes with practice. So even doing after 3 or 4 patients, you would get the hang of it”. • “I think, um, doing case scenarios like this is really helpful, in teaching, as a teaching tool. Um, because then you, it’s sort of like a real life scenario, where it’s not just a classroom, saying, you click here for this, it’s like actually putting it through, and I thought that was really helpful”

  18. Limitations • Generalizability • Female Population • Case Scenario

  19. Conclusions and Implications for Practice • Transfer of knowledge through: • Repetition and Practice • Case Scenario • Novice Users Skill Needs. • Early in Curriculum • Reconfiguration of curricular content • Future Research

  20. Thank You Stephanie Jones – sjones89@uwo.ca Lorie Donelle – ldonelle@uwo.ca

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