Nursing Education For Electronic Health Records

 Electronic Health Record and Nursing Education

 What Are Electronic Health Record,Implementation of Electronic Health Records,Electronic Record Versus Paper Record,Role of Nursing Faculty and Education.

What Are Electronic Health Record

    Traditionally, patients' health records were paper based, and nursing students learned documentation skills by entering information under the supervision of the clinical faculty (Baillie, Chadwick, Mann, & Brooke-Read, 2013). The move to electronic-based health records was legislated in the United States in the Health Information Technology for Economic and Clinical Health Act (2009). According to this legislation, a qualified electronic health record (EHR) includes patient demographic and clinical health information, such as medical history and problem lists, and has the capacity to support clinical decisions; support physician order entry; capture and query information relevant to health care quality, and exchange electronic health information with, and integrate such information from, other sources. 

    The goal of the federal legislation was to have an EHR used for each person in the United States by 2014. Nursing students need information about different EHR systems including their strengths and limitations in accessing essential information at the point of care, communicating across disciplines and settings , coordinating care, and guiding patients through the many transitions that comprise the health care experience (Mahon, Nickitas , & Nokes , 2010). Some nursing education programs are purchasing academic EHRs that have the characteristics of a qualified EHR along with an educational component that enables assessment of the student's documentation and feedback to the student through comments and grading in the electronic format (Hanson, 2013).

Implementation of Electronic Health Records

    There are many EHRs being developed and sold in the health care marketplace. As nursing students rotate through different clinical sites during their educational program, they are exposed to different EHR systems; however, there are a number of barriers that impact on whether students are able to document using the clinical agency's EHR. Rather than being given opportunities to experience in simulated settings the mistakes and frustrations inherent in using EHRs. health professional students often embark on a haphazard and variable learning curve in patient care settings, where their EHR education is directed by faculty with differing skill levels (Milano, Hardman, Plesiu, Rdesinski , & Biagioli , 2014 )

     Educators have responded to the need for students to have electronic documentation skills by using academic EHR during simulation experiences that encourage critical thinking while allowing for errors. Vendors: supplying academic EHR include SimChart by Elsevier, Neehr Perfect, and Cerner's Academic Education Solution (AES). Borycki , Joe, Armstrong, Bellwood, and Campbell (2011) described an open-source system, the University of Victoria Interdisciplinary Electronic Health Record Educational Portal, which allows access to a number of EHR systems for health professional students. 

    Anest (2013) described how pre-licensure nursing students were taught medication administration using barcode technology, while interprofessional students (pharmacy, nursing, physical therapy, and physician assistant) used the MEDITECH software package (Medical Information Technology, Inc. Westwood, MA) to simulate the medication administration and documentation ( Kirwin , DiVall , Guerra, & Brown, 2013). 

    Meyer. Sternberger , and Toscos (2011) described experiences with AES, while, to avoid the costs associated with purchasing an EHR system, Rubbelke , Keenan, and Haycraft (2014) used Google Drive, a cloud storage device that stores documents and can be synced with a free Google account. Another strategy that faculty have used is to partner with the EHR system used in the clinical setting in order to have access to the same EHR system for student practice.

Electronic Record Versus Paper Record

    The transition from paper based record to EHRS is a worldwide phenomenon. Use of EHR has been associated with better care coordination, continuous access to evidence, information exchange between providers, and improved client engagement in health and self-care processes (Topaz, Rao, Creber, & Bowles, 2013). The cost of using an academic EHR has been estimated to be at an expense to each student of at least US$35 to US$49 per semester ( Rubbelke , Keenan, & Haycraft , 2014). Not only do faculty need to learn skills associated with using EHR, they need to communicate these skills to students who are novices in clinical practice.

Role of Nursing Faculty and Education

    Nursing faculty and students must develop competence in EHR documentation skills and establish clear systems for authorized access so that students can document during clinical placements (Baillie et al, 2013).Health professional educational programs should collaborate as they choose academic EHR systems and develop curricula modules so that not only documentation skills are taught but also the importance of communication between members of the health care team.