Date of Award

Summer 2024

Project Type

Thesis

College or School

CHHS

Department

Nursing

Program or Major

Direct Entry Masters in Nursing (DEMN)

Degree Name

Master of Science

First Advisor

Pamela Kallmerten, PhD, DNP, RN, CNL

Second Advisor

Katherine R. Willetts, DNP, RN

Abstract

Background: Use of Electronic Medical Records (EMRs) has become the standard for medical information management and exchange amongst acute care hospitals in the United States. The Epic® electronic medical record has been identified as a popular EMR software for adoption by many healthcare organizations. Associated with the adoption of this technology is a large investment in training medical professionals on its specific processes.

Local Problem: In the outpatient, primary care setting of a hospital in New England, the adoption of Epic® has come with much fear and resistance regarding the ability of nursing staff to efficiently learn and accept the new technology. This was confirmed through the analysis of an anonymous pre-intervention survey by nursing staff, majority of whom were over the age of 50. The pre-intervention survey showed that the perceived ease of learning Epic® was lowest with a mean of 2.92 (SD 1.15, Range 1-5). The highest mean of 3.76 (SD 1.05, Range 1-5) was noted for the perceived usefulness of Epic®.

Methods: A survey was administered in May 2024 which analyzed nursing perceptions of the Epic® electronic medical record. The survey contained 6 sections: (1) participant demographics, (2) perceived usefulness of Epic®, (3) perceived usability of Epic®, (4) perceived ease of learning Epic®, (5) individual satisfaction with Epic® , (6) free text asking users to solicit the most positive aspects and negative aspects of the EMR, and which aspects of the technology they would like to receive additional training on. Sections 2-5, derived from a standardized questionnaire known as the USE questionnaire (Lund, 2001) were analyzed for mean scoring across all participants. Interventions were made based on responses from the free text responses. The survey was re-administered in July 2024 to compare mean scoring and identify if perceptions of the EMR had improved based on the educational interventions provided.

Interventions: Requests solicited from the free text responses in the pre-intervention survey were analyzed to identify themes and patterns, which would then be used for development of electronic video tutorials created by the project lead. Each tutorial provided a live demonstration of the respective process being executed in the EMR. Videos were then uploaded to a shared digital space where all participants could access for viewing.

Results: Post-intervention survey results measured staff acceptance of the technology across four domains: (1) perceived usefulness, (2), perceived usability, (3) perceived ease of learning, (4) satisfaction with the EMR. Analysis showed a 7.28% increase in staff perceptions towards ease of learning, with a change of aggregate mean from 2.92 to 3.15. All other domains showed a decrease in perceived usefulness, usability, and satisfaction with Epic®, when comparing pre- and post-intervention analysis.

Conclusion: The educational interventions showed an improvement in how nursing staff perceived the software from an ease of learning standpoint, emphasizing its potential to improve perceptions across other domains. To sustain and preserve these teachings, future efforts should be made by leadership to incorporate e-learning in the training of nurses on Epic® and other applicable technology.

Keywords: Epic®, Electronic Medical Records, e-learning, Primary Care, USE questionnaire, Technological Education

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