Presentation
Work System Barriers and Mitigating Strategies Affecting Nurses EHR Use in a Critical Care Unit: A Multi-Site Qualitative Interview and Observation Study Using a Human Factors Approach
SessionPoster Session 2
DescriptionElectronic Health Records (EHRs) offer numerous benefits in healthcare, yet critical care nurses continue to face significant barriers when integrating EHR use into their clinical workflows. This multi-site qualitative study explored work system challenges and adaptive strategies related to EHR use among 30 bedside nurses in neonatal and pediatric intensive care units (NICU and PICU) across two academic medical centers. Using the Systems Engineering Initiative for Patient Safety (SEIPS) model as a guiding framework, we conducted 1–3-hour observational sessions followed by semi-structured interviews. Thematic analysis revealed multiple barriers, including competing clinical demands, frequent interruptions, and inefficiencies in external tools linked to the EHR. Nurses developed both individual and team-based strategies to overcome these challenges, such as leveraging "buddy" nurses for documentation support, using EHR shortcuts to streamline documentation, and incorporating virtual "base" nurses to assist with monitoring and charting. These findings highlight the persistent misalignment between EHR design and the dynamic, high-stakes environments of critical care. Addressing these issues requires a human factors approach that centers on the realities of nursing work. Future improvements in EHR systems must focus on enhancing usability and integrating workflow-aligned features to better support critical care nursing practice.
Contributors
Event Type
Poster
TimeWednesday, October 15th5:30pm - 6:30pm CDT
LocationRiverside East
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