Nurses are being left behind when it comes to planning and implementing electronic health records. That’s a core finding in the third quarter 2014 Black Book EHR Loyalty survey being published later this month.

The survey of nearly 14,000 U.S. nurses found that 98 percent of licensed RNs say that they have never been included in hospital technology decisions or design. And, within for-profit hospital facilities, just 15 percent of the surveyed nurse respondents believe their IT department that supports the EHR is knowledgeable and receptive to nurses’ suggestions in improving electronic documentation.

In addition, dissatisfaction with inpatient EHR systems among nurses has reached an all-time high of 92 percent. Disruption in productivity and workflow has also negatively influenced job satisfaction according to 84 percent of surveyed nurses, while 85 percent of state they are struggling with continually flawed EHR systems. Further, 88 percent blame financial administrators and CIOs for selecting low-performance systems based on EHR pricing, government incentives and “cutting corners at the expense of quality of care.”

Moreover, 84 percent of surveyed nursing administrators in not-for-profit hospitals, and 97 percent of counterparts in for-profit hospitals confirm that the impact on nurses’ workloads, including the efficient flow of direct patient care duties, were not considered highly enough in their administration's final EHR selection decision.

“Although the inpatient EHR replacement frenzy has calmed temporarily, the frustration from nursing EHR users has increased exponentially,” said Doug Brown, managing partner for Black Book Market Research, in a written statement. “The meaningful use financial incentives for hospitals have many IT departments scurrying to implement these EHRs without consulting direct care nurses, according to the majority of those polled by Black Book.”

Among other findings of the survey:

* 90 percent of EHR nurse users attested that the use of the current EHR system in their facility has negatively impacted communications between nurses and their patients.

* 94 percent of nurses do not believe that the use of their current EHR has improved communication between the nurse and the care team (physicians, respiratory therapists, physical therapists, occupational therapists, pharmacists, etc.).

* Only 26 percent agree with the statement, “As a nurse, I believe the current EHR at my organization improves the quality of patient information.”

* 69 percent of nurses in for-profit inpatient settings report their IT department as “incompetent” when describing the level of expertise their organization’s in-house staff has working with the selected EHR software.

The survey also reveals that hospital nurses are being forced to develop “creative workarounds” to deal with EHR system flaws. Among the EHR vendors ranked lowest in nursing satisfaction, 89 percent of nurses report developing workarounds to deal with shortcomings and system deficiencies that are not addressed or corrected after reporting issues to IT and nursing supervisors. And, 67 percent of nurses reported they have been taught workarounds to allow other health team members to view pertinent information related to a patient, as to not lower the quality of care, yet avoiding the EHR systems’ unresolved flaws.

In May, the 185,000-member National Nurses United launched a nationwide media campaign railing against the dangers of “unproven” medical technology and a lack of standardized care that exposes patients to “severe risk of harm.” Though hospitals and other healthcare facilities are spending billions of dollars on medical technology “sold to the public as the cure for everything from medical errors to cutting costs,” NNU argues that the reality is proving to be far different, according to the nurse union’s media campaign—which included radio ads, video and social media.

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