Discussion
The study aimed to address ethical issues with EHR utilization of EHRs among novice nurses. A systematic literature review was conducted to collect data on novice nurses’ ethical utilization of EHRs. Various studies were extracted using inclusion criteria, and those that met the required terms were used to search for relevant data on enhancing the ethical use of EHRs among novice nurses. A thematic analysis was also used, which showed recurring themes, which included initiating training programs for novice nurses, implementing user-friendly systems for more straightforward utilization, enabling effective communication between novice nurses and other practitioners, and measuring novice nurses’ satisfaction levels while utilizing these EHRs. The discussion part will consist of a well-detailed interpretation of the findings from the results section, strengths, and limitations of the study.
The application of computers and communication technologies will impact more lives positively in this century than any other technology. As the largest group of healthcare practitioners who document, more than any other discipline in acute care facilities, nurses are at the forefront of ensuring that EHRs are patient-centered and contribute to safe, ethical practices (Rathert et al., 2019. As indicated in the literature review and the results, the utilization of EHRs can result in a unique set of ethical and legal complexities. Novice nurses need to be prepared to face these challenges and identify the requirements of state and work policies and obligations of the nursing profession. A study by (Hariyati et al. 2018) showed that novice nurses spent a majority of their time in documenting patient data in the EHR systems, indicating the need for appropriate utilization of EHRs to meet quality of patient care. With necessary guidance, nurses can document relevant data accurately and in a manner accessible to the interprofessional team.
Documentation using EHRs needs to follow certain principles, namely, factuality, accuracy, and completeness. Patient data needs to be accurate and precise to provide a basis for the contribution of nurses to patient outcomes and the availability of health care facilities (Rathert et al; Kinnunen et al. 2019). Documentation that fails to meet these principles can result in undesirable patient outcomes for nurses, patients, and health care facilities. Novice nurses need to maintain competence and follow ethical guidelines when documenting, to demonstrate decipherable and inclusive reporting (Winstanley et al. 2017).
Quantitative studies from (Kruse et al. 2017; Winstanley et al. 2017; Vekho, 2019; and Groot et al., 2020) indicated that EHRs provide numerous benefits to patients, clinicians, and health care facilities. However, these technological advancements tend to raise ethical questions that need to be addressed before adverse impacts emerge such as medical errors, false alarms, breach of patients’ information privacy. Provision of care in this digital requires critical evaluation of the effects of such technologies on patient care and safety (Groot et al., 2020). The application of disruptive technologies such as EHRs in clinical settings can result in opportunities and risks, as stated by (Ahmed et al. 2023).EHRs have been reported simultaneously to facilitate and complicate delivery of care to patients(Barret et al. 2017; Wisner et al. 2019, Shachak et al. 2019; and Bristol, 2018). The search for evidence on EHRs by (Bristol, 2018) indicated that EHRs should help in facilitating patient care, supporting nurses’ ethical mandates, and enhancing proper stakeholder relationships.It is evident from a study conducted by Shachack et al( 2019) that with efficient training, the design and implementation of these systems can enhance patient safety and quality care. These disruptive technologies need to add value to patient experiences by improving patient care by creating time to tend to patients, even with technologies such as EHRs.
The study also helped understand that information retrieval interoperability help in enhancing the ethical use of EHRs when delivering quality care. However, it can also create unwanted risks if not utilized ethically. Such ethical issues include unauthorized access to patient information and leaking it to other unauthorized personnel. Unauthorized access to patient information raises ethical questions and can have adverse implications for patients and their families (Kroth et al. 2019). This is why (Alrasheeday et al. 2023; Vekho, 2019 and Byard et al. 2018) stated that it is important for relevant stakeholders to collaborate and develop clear ethical guidelines to be followed by practitioners in clinical settings. Research conducted by (Byard et al. 2018) revealed that most patients prefer non-disclosure of their data because genetic details are involved. Therefore, novice nurses need to be trained efficiently on the importance of autonomy, which demands that the encounters and information linked to patients’ diagnosis and treatment remains confidential so that they can foster trust and enhance communication. Ethics when handling patient data should always be observed by novice nurses and other health care professionals.
EHR utilization of EHRs calls for high ethical sensitivity and awareness among novice nurses. Moral sensitivity is considered an essential precursor to ethical decency (Alrasheeday et al., 2023; Shachak et al., 2018). Notably, this is because recognizing ethical content-related practice is imperative to healthcare practitioners in their attempt to deliver quality care (Kroth, 2019). According to Atasoy (2019), EMRs provide a range of benefits to patients and nurses, but their utilization raises ethical questions. It is difficult to navigate through the provision of care in this digital era precisely, therefore requiring proper evaluation of these technologies’ impact on quality care and patient safety (Barrett et al. 2017 and Bristol et al. 2018). According to (), the utilization of technology requires that novice nurses be trained efficiently to enable them to accurately capture, retrieve, and organize patients’ data within the healthcare industry.
As (Ahmed et al. 2023) stated, nurses often integrate digital data with other sources of data in the process of providing care using health information technologies. Further, (Darrudi et al. 2017) discovered that utilization of EHRs often leads to moral distress in novice nurses. Additionally, while evaluating the experience of novice nurses with significant utilization of EHRs, (Wisner et al. 2019) stated that the age of a nurse and the maturity of the EHR system in the healthcare facility has an impact on nurses’ satisfaction. Measuring their satisfaction levels helps in knowing how well nurses are acquainted with these systems and enhances ethical utilization when delivering care. Healthcare facilities must prioritize patients’’ safety and constantly apply ethical guidelines.
Technologies have been shown to underscore the ethical values in nursing practice. According to (Winstanley, 2017; Tubaishat, 2017, and Darrudi et al. 2017), EHR results in unintended repercussions for patients’ safety and quality care. Novice nurses need to confront many utilization complexities, such as gaining knowledge on the utilization of EHRs through practical training, implementation of user-friendly systems, interoperability, and support from relevant stakeholders. They also need to apply various ethical decision-making models to support them in taking necessary actions to foster quality care. Previously, to address the ethical dilemma in incorporating EHRs into nursing practice, the only strategy applied in addressing the knowledge gap in practice was the revision of moral guidelines (Tubaishat, 2017). Healthcare facilities are urged to develop practical, ethical guidelines in relation to the utilization of EHRs; further, they are encouraged to address the gaps in practice with practical solutions.
Proper oversight of EHRs needs to be conducted regularly by hospital management. It ensures that these systems are utilized efficiently and effectively for the appropriate purposes. A sense of ownership is necessary for certain functions of the implementation processes operations. Further strict monitoring must be enhanced to ensure the processes run smoothly (Darrudi et al., 2017; Tubaishat, 2017). Various features need to be considered, entailing the responsibility of those individuals assigned essential tasks to handle EHRs. Independent bodies play a vital role in overseeing and evaluating these systems and examining the validity of their implementation.
Strengths and Limitations
The study had several significant strengths and limitations. The first strength is the quantity and scope of literature; the researcher only identified a limited article with quantitative data. The researcher relied on scientific journals, and analysis processes were proven through various software. The second strength was synthesizing the effect that non-ethical utilization of EHRs had on patient safety and quality care. The researcher found relevant articles on its impact on patient safety and how these effects can be addressed. The study also suggested various notable future directions in this field. First, more information is required regarding multiple issues involved in the unethical utilization of EHRs when delivering care. Additionally, it addresses various strategies to enhance the ethical use of EHRs in healthcare settings. The researcher had the limitation of focusing only on peer-reviewed articles and journals rather than on healthcare facilities to help in understanding better the impacts unethical utilization of EHRs by novice nurses has on patient safety and quality care.
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