Electronic medical records, nurse staffing, and nurse-sensitive patient outcomes: Evidence from the national database of nursing quality indicators

Michael F. Furukawa, Raghu Santanam, Benjamin Shao

Research output: Contribution to journalArticle

28 Scopus citations

Abstract

Electronic medical records (EMR) have the potential to improve nursing care in the hospital setting. This study estimated the association of EMR implementation with nurse staffing levels, skill mix, contract/agency percent, and nurse-sensitive patient outcomes in U.S. hospitals. Data on nurse staffing and patient outcomes came from the 2004-2008 National Database of Nursing Quality Indicators. Data on EMR implementation came from the 2004-2008 HIMSS Analytics Database. The authors conducted a longitudinal analysis of an unbalanced panel of 3,048 medical/surgical units in 509 short-term, general acute care hospitals. EMR implementation was associated with lower total nurse hours per patient day, higher Registered Nurse percent and contract/agency percent, and higher adverse patient events in the short term. EMR may create a skill bias toward higher-skilled nurses. As more advanced EMR systems diffuse into practice, managers and policy makers should consider potential negative associations of EMR implementation with patient safety.

Original languageEnglish (US)
Pages (from-to)311-331
Number of pages21
JournalMedical Care Research and Review
Volume68
Issue number3
DOIs
StatePublished - Jun 1 2011

Keywords

  • efficiency
  • electronic medical records
  • health information technology
  • nurse staffing
  • patient outcomes

ASJC Scopus subject areas

  • Health Policy

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