Measuring nursing benefits of an electronic medical record system: a scoping review

Background: Nurses are expected to be the largest users of electronic medical records in hospitals. Literature specific to measuring the impacts of an electronic medical record implementation on the quality of nursing work has not been examined. Aim: Report a scoping review to identify measures useful to evaluate the nursing benefits of electronic medical records implementation in the Australian hospital context. Methods: Search terms included combinations of synonyms for: nursing, electronic medical record, and healthcare quality. Data were extracted from eligible papers using an established five-step scoping review process. Eligible papers and extracted data were independently checked by two reviewers. Findings: 120 papers were located by systematic searching of five databases and grey literature from peak bodies. A framework integrating three domains of nursing work with Donabedian's quality model resulted in a matrix of 168 measures relevant to evaluating technology impact on the quality of nursing work. Discussion: Measures addressed structures, processes and outcomes of nursing work for fundamental nursing care and harm prevention; however a gap emerged in relation to measuring individualised nursing care. Variability in measures and mixed reports of impacts of electronic medical records on nursing work and patient care delivery were identified. Conclusion: The scoping review identified measures useful to inform a quality assessment framework to examine nursing benefits of electronic medical records in Australian hospitals. Next steps include testing the validity, reliability and sensitivity of indicators to evaluate the impact of an implementation strategy. Future research should identify measures to examine quality of individualised care.