Examining nurses’ acceptance and use of electronic health records in resource-limited healthcare settings

Abstract

Background: Electronic health records were introduced to revolutionize record keeping in healthcare. When used as intended, EHRs have been reported to improve patient care and care coordination, improve data integrity, and enable easy exchange of information between authorized users. However, achieving these benefits heavily relies on acceptance and use. Purpose: The aim of this study is to identify, understand and examine factors that influence nurses’ behavioural intention, and actual usage behaviour of EHRs in resource-limited settings. Also, there is a need to explore nurses’ perceptions of the comfort levels, barriers, and facilitators to EHRs use to better understand acceptance and use in resource-limited settings.

Methodology: A cross-sectional study was conducted to explore the perception of nurses about EHRs using a convergent mixed-methods design to collect quantitative and qualitative data. A research questionnaire was administered to a total of 193 nurses in 54 healthcare facilities across eight DHMTs in Botswana’s resource-limited settings. The collected data was analyzed using SPSSv26 and NVIVO software.

Findings: The findings identified individual, technological, and organizational characteristics as factors influencing nurses’ behavioural intentions, comfort levels, and actual user behaviour. In addition, this study found the influence of moderators on the main study variables. Lastly, this study also identified barriers to EHRs use and reasons why nurses use EHRs in resource limited settings within Botswana.

Conclusion: The findings of this study highlighted the need for the involvement of nurses in the development of EHRs and for nursing institutions to add EHRs education to nursing curricula to produce EHRs usage-ready graduates. Since technological issues arose, this study also emphasized the need for dedicated IT personnel to curb support and maintenance deterrents. The is also a need for health facilities to employ more nurses or EHRs dedicated personnel to ease the problem of workload and understaffing to the improvement EHRs utilization.