Student Nurse’s Perception of Electronic Medical Records (EMR) of Patients at ECWA Hospital Egbe, Kogi State
Chapter One
General Objective
With the ultimate goal of evaluating the quality of care utilizing the Hospital’s approach, structure, and EMR results, the overall objective is to assess student nurses’ perceptions of electronic medical records (EMR) in relation to high-quality healthcare at ECWA Hospital Egbe.
Research Objectives
- To study the use of EMR in the ECWA Hospital Egbe
- To determine the behavioral intent to use EMR among nurses in ECWA Hospital Egbe
- To study the student nurses perception on electronic medical records (EMR) on quality of care among nurses and clients in ECWA Hospital Egbe.
CHAPTER TWO
LITERATURE REVIEW
Introduction
This section presents the theoretical and empirical literature related to the research. The section opens with an overview of EMR and several definitions. The history and benefits of digital health records are discussed in the next section. Once more, a presentation is given on the elements and difficulties of electronic medical records. The chapter also emphasizes measurement and quality control in healthcare. The presentation on the company’s model for implementing new technologies comes next. Following an empirical evaluation of the effects of EMR on care quality, the chapter’s summary follows.
Electronic medical Record System Overview
Due to the rapid advancements in information technology over the past 20 years, various digital health records (EMRs) have been developed and put into use, particularly in the healthcare industry. Several organizations or nations are now planning a national electronic medical record, while others have successfully implemented an EMR of some description (Zhang, R. et al 2010).
Yet, different countries may have different definitions of what an electronic medical record is and how it is used. Although while organizations and nations have studied the use of computerized healthcare data systems for patients, few hospitals have successfully implemented clinical data-level electronic medical records. (2000) (Grimson et al.).
Despite the fact that emerging and advanced countries often have a lot of interest in automating health records.
Regrettably, many health care providers, administrators, and managers of medical records and health data seem to find the installation of an EMR plan to be daunting and nearly impossible to accomplish. What causes this? Technology accessibility may not be the sole obstacle; support from experts and the cost of switching to an electronic system may both be factors. These elements come together with inadequate funding for health care. Cost, accessible technology, a lack of technical know-how, proficiency with personal computers, and the absence of data processing facilities in many developing countries are actually significant obstacles that must be resolved before deployment is practical. (WHO, 2006). In light of the aforementioned, it may be difficult to transition some medical practitioners and other health professionals from manual to digital recording. The majority of data and health executives are aware that changing or altering the behavior and attitude of health practitioners may take some time. (WHO, 2006).
Defining an Electronic medical Record
If people refer to what they have used as an electronic medical record, they may not be the same as other electronic medical records produced in various institutions / countries. That might be perplexing. It might be a long-term record that’s commonly accessible in lots of different organizations. In other cases, it operates as a restricted automated system that can only be accessible by members of a particular unit or department. Thus, it’s critical to comprehend the terminology that are being utilized and to establish the nature and scope of your institution’s / nation’s digital health record system.
Over time, a variety of words have been used to characterize the transition from a manual or paper-based record to an electronically generated record. AHR, Electronic Medical (EMR), and Electronic Medical Records are a few more well-known brands (CPR). (WHO, 2006).
Automated Health Records (AHR)
A collection of computer-stored pictures from traditional health records was described using the word Automated Health Records. This looked at issues with accessing, storing and controlling paper-based files but failed to fix patient input / output. (WHO, 2006).
Electronic Medical Record (EMR)
The term Electronic Medical Record, or EMR, was used to describe digital systems based on images of documents or systems set up in a medical office or community health center, similar to the term Automated Health Records. They were frequently utilized by general practitioners in many developed nations, including patient identity information, medicine, the creation of prescriptions, and laboratory test results. In some circumstances, every piece of medical information given by the doctor is included during each patient’s appointment. In some countries, like Korea, the term “EMR” is used to denote an electronic hospital recording system that entails clinical data entered by the healthcare provider at the point of care (WHO, 2006).
CHAPTER THREE
RESEARCH METHODOLOGY
Introduction
The Chapter mentions the procedure by which the work was conducted. It comprises of the research paradigm which explains the worldview of philosophical issues underpinning Electronic medical Records and Quality of Care. The approach to the study also explains the method that was used to carry out the study, hence the qualitative research approach. The research design, sources of data, sampling technique, sampling size, the target population, data collection instruments, the key constraints to this study as well as the ethical consideration are all part of this Chapter.
Research Design
For this study, the case study research design has been adopted. Case surveys are an investigative approach in which the investigator investigates a program, event, activity, process or one or more people in depth. (Creswell, 2009). Baskarada (2014) describes a case study as an empirical investigation that explores a phenomenon in depth and in its real-life context, particularly when the limits between phenomenon and context are not evident. The case study was regarded because it highlights the depth that is crucial to my study as the investigator attempted to determine the impact of electronic medical records on quality of care. (Rose, Spinks & Canhoto, 2015). The case study enabled the ECWA Hospital Egbe to thoroughly research the phenomenon of impact of electronic medical records on quality of care. It helps to clarify real-life situations complexities. The case study was used as it enabled different data sources (observations, interviews and documents) to be used to request data on the effect on quality of care of electronic medical records.
Study Population
The research population includes the ECWA Hospital Egbe nurses in departments operating with electronic medical records. It also consists of hospital-accessing customers. To be included in this research, respondents in a department using EMR for service delivery in ECWA Hospital Egbe must have been health care providers. The participant will be needed to have hospital experience and provide direct Electronic medical Care and/or quality assurance / improvement team member of the hospital. The chosen people should have quality healthcare and Electronic medical Record experience and are prepared to discuss their perceptions of the EMR system’s usefulness and impact.
CHAPTER FOUR
DATA ANALYSIS AND DISCUSSION
Introduction
The chapter presents the data collected through analysis based on the objectives. The analysis begins with background to the analysis as well as data screening, frequencies and percentages of the profile of respondents. It also includes thematic analyses of the various variables of the study. The second part of this section deals with the discussion of the findings.
CHAPTER FIVE
SUMMARY, CONCLUSION AND RECOMMENDATIONS
Introduction
The chapter summarizes the key findings, provides adequate conclusions as well as proposing appropriate recommendations for practice and research.
Summary of Findings
The aim of the research was to evaluate student nurses perception on electronic medical records (EMR) on quality healthcare at ECWA Hospital Egbe using the method, structure and outcome of EMR at the Hospital to measure the quality of healthcare. The research attempted to accomplish its objective through three goals: examining the acceptance, execution and use of the EMR at ECWA Hospital Egbe among both employees and patients; examining the behavioral intent of using the EMR scheme among ECWA Hospital Egbe employees; and to examine the benefits and impact of the EMR system on the quality of healthcare delivery among both nurse and clients at the ECWA Hospital Egbe. The study sought to measure its objectives by adopting a qualitative approach with a cross-sectional explanatory design by gathering data through the use of interview guide from a sample size of 11 respondents (6 nurses & 5 patients). The information were analyzed using the method of thematic assessment. The overview of the main results disclosed that the EMR scheme is mainly used in all hospital departments, the documents being fully maintained using HER, and nearly all interview respondents recognize that they would like to continue to use the HER. The results of the study illustrated that participants expressed the need for the continuation of the EMR scheme and the fact that it provides positive feedback from patients on its quality and enhance the level of satisfaction. Key findings indicated that management benefits a great deal from the EMR system through quality records of patients, simultaneous patient care, quality requirements, and faster and easier appointment reservations, among others. The assessment disclosed that there is no discrimination in using the EMR, waste avoidance, time-waste decrease and damaging delays, respectful and responsive healthcare, no harm to patients is caused by using EMR or manual and other healthcare results. The effect of the EMR scheme is apparent in the system’s triage, end-user satisfaction, relatively low cost of using EMR and other appropriate services related to the use of HER. However, due to its advanced nature requiring a lot of web information, qualified labor force and regular maintenance, some other participants had a mixed impression about the program concerning its sustainability. The results disclosed some system problems such as hardware infrastructure procurement, end-user incapacity, billing problems, redundancy problems, waiting time, and missing data / information problems.
Conclusion
The adoption, implementation and use of the electronic medical record technology is a vital component of health service management in health organisations that seeks competitive advantage. As such, healthcare quality is predicted by the full implementation and sustenance of the EMR system in health organisations. This relationship in the hospitals is agreed to be of primary concern to all major stakeholders in the health sector. Also, improving quality of healthcare delivery is one of the most important factors in present day health facilities. Patients or clients expect quality without compromise from healthcare givers. This was tasked to examine the impact of the EMR system on the quality of healthcare delivery at the ECWA Hospital Egbe. The study demonstrated that the EMR system to a very large extent affects the quality of healthcare delivery in the ECWA Hospital Egbe. The key findings indicated that, management benefits a lot from the EMR system through that quality of patients’ records, attending to patients simultaneously, quality requisitions, faster and easier booking of appointment, no discrimination, avoidance of waste, reduction in time wasting and harmful delays, respectful and responsive healthcare, end user satisfaction of the system, relative low cost of using EMR among others. The EMR system is however saddled with problem of procurement of the hardware infrastructure, end user inability, billing issues, redundancy issues, waiting time and missing data/information issues. Therefore, the study concludes that the EMR system should supported and sustained by the Hospital and concrete steps should be taken to curb the emerging challenges encountered by the use of the EMR system.
Recommendations
The study proposed appropriate recommendations based on the recommendation for practice, policy formulation and for future researchers.
Recommendation for Practice and Policy
The study recommends that the University Hospital (ECWA Hospital Egbe) needs to fully maintain and sustain the EMR system, as it is proven to have several benefits for the hospital. Even though the implementation of the EMR system may be costly, its benefits certainly outweighs the cost of operations.
The study recommends that the Hospital should take proactive steps in training its human resource on the EMR system. This training programme should include activities that can enhance and improve the nurse understanding of the EMR system and how to apply at real work settings.
Health service organisation in Nigeria must endeavour to review the recent technologies used in enhancing healthcare delivery and implement better schemes that would lead to higher user satisfaction of their workers. These health organisations could institute electronic medical record systems that are not only more flexible to the internal users such as workers in the hospitals but also external users such as patients or clients and customers. This could boost their healthcare delivery and promote worker contentment which could result in greater output for the organisation.
Also, other health service organisations especially the hospitals must endeavour to ascertain and sustain the EMR schemes since these schemes enhance quality healthcare delivery. Quality healthcare and end user satisfaction are dynamic and thus, the management of the ECWA Hospital Egbe and other hospitals could research within the industry to find out where they need to improve in order to engender greater quality of healthcare, nurse and patient satisfaction, and commitment.
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