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International eHealth strategies incorporate the adoption of electronic health records to enhance the delivery of integrated healthcare and improve patient outcomes. Nurses’ acceptance of electronic health records is crucial for their successful implementation.
To synthesise evidence from empirical studies to explore the nurses' perceptions of facilitators and barriers and the influence of moderating factors on their acceptance of electronic health records.
A convergent integrated mixed-method systematic review following the JBI methodology.
CINAHL Plus with Full Text, Medline [EBSCO], ProQuest, PubMed, Scopus, Google Scholar and Open Grey were searched on 28 March 2023 for primary research studies published between 2018 and 2023.
Studies were screened by two independent reviewers adhering to predetermined inclusion criteria. A convergent integrated synthesis was conducted and deductive analysis was framed by The Unified Theory of Acceptance and Use of Technology model.
Thirteen studies were included and appraised using the mixed-method appraisal tool. Facilitators of nurses' acceptance of electronic health records included increased efficiency, improved access to information, management support and training. Nurses identified increased documentation burden, threats to patient confidentiality, difficult navigation and inadequate IT support and training as barriers to their acceptance. The influence of moderators on nurses' acceptance of electronic health records remains unclear.
This review provides insights into nurses' perceptions of factors influencing electronic health record acceptance. Addressing these issues during adoption and further exploring the impact of moderators can improve acceptance and minimise unintended consequences.
Nurse leaders are key in empowering nurses to accept electronic health records. The nursing profession must participate in all phases of electronic health record design and implementation to ensure that they complement nursing practice.
PRISMA 2020 Statement.
This is a review of primary research.
To synthesise evidence from studies that explored the impact of electronic and self-rostering systems to schedule staff on healthcare organisations and healthcare workers.
Mixed-method systematic review.
Studies were screened by two independent reviewers and data were extracted using standardised data extraction tables. The quality of studies was assessed, and parallel-results convergent synthesis was conducted.
Academic Search Complete, CINAHL, ERIC, MEDLINE, PsycINFO and PsycARTICLES were searched on January 3, 2023.
Eighteen studies were included (10 quantitative descriptive studies, seven non-randomised studies and one qualitative study). Studies examined two rostering interventions including self-rostering (n = 12) and electronic rostering (n = 6). It was found that the implementation of electronic and self-rostering systems for staff scheduling impacted positively on both, healthcare workers and healthcare organisations. Benefits included enhanced roster efficiency, staff satisfaction, greater control and empowerment, improved work-life balance, higher staff retention and reduced turnover, decreased absence rates and enhanced healthcare efficiency. However, self-rostering was found to be less equitable than fixed rostering, was associated with increased overtime, and correlated with a higher frequency of staff requests for shift changes.
The impact of electronic and self-rostering systems to schedule staff on healthcare organisations and healthcare workers’ outcomes was predominantly positive. Further randomised controlled trials and longitudinal studies are warranted to evaluate the long-term impact of various rostering systems, including electronic and self-rostering systems.
Rostering is a multifaceted responsibility for healthcare administrators, impacting patient care quality, workforce planning and healthcare expenditure.
Given that healthcare staffing costs constitute a substantial portion of global healthcare expenditure, efficient and strategic resource management, inclusive of healthcare staff rostering, is imperative.
The 27-item Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) checklist.
No Patient or Public Contribution.
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