Date of Award
Spring 5-11-2024
Document Type
Thesis
Degree Name
Master of Science in Nursing Administration and Emergency Management
Department
Nursing
College
College of Education and Health
Committee Chair
Dr. Shelly Randall
Second Committee Member
Dr. Jennifer Helms
Third Committee Member
Dr. Melissa Darnell
Program Director
Dr. Jennifer Helms
Dean of Graduate College
Dr. Sarah Gordon
Abstract
“Unintended consequences are unexpected, and unwanted outcomes that can limit the value of EHR implementation and adversely affect quality of care and patient safety” (Lee & Kang, 2021, p. 898). Few organizations have redesigned the EHR to improve usability to mitigate potential patient safety concerns. This study aims to identify unintended consequences in patient care workflows and determine educational needs related to EHR usability. A mixed method approach was used to investigate unintended consequences in deidentified patient safety reports submitted Jan 1, 2020, through December 31, 2023. The data was analyzed to identify error types and educational deficits. The Acute Care campus accounted for the majority (89%), n = 57 of total Joint Patient Safety Reporting (JPSR) incidents with a minority (11%), n= 7 of total JPSR reports on the Long-Term Care campus. Human error was attributed to 100% of all reported JPSRs. The quantitative data revealed a significant increase in reports between 2021 and 2022, with most reports originating in the Nursing Acute and Nursing Critical Care service lines. These service lines care for complex patients, which may have led to more JPSRs and suggest a correlation between patient acuity and the frequency of reports. Additionally, it is important to consider that an increase in errors could have also contributed to the higher frequency of reports. This implies that additional staff is needed to support these areas to increase patient safety. An analysis of submissions and outcomes of Joint Patient Safety Reporting (JPSRs) over four years, 2020-2023, revealed three high-frequency error types: Manual Release, Misinformation, and Patient Movement. These findings highlight the importance of addressing human factors through education and training.
Recommended Citation
Powell, JoEtta, "The Impact of Electronic Health Record Unintended Consequences on Quality of Care Within a High Complexity Healthcare Organization" (2024). ATU Theses and Dissertations 2021 - Present. 66.
https://orc.library.atu.edu/etds_2021/66