Columbia University School of Nursing, New York, New York.
J Am Assoc Nurse Pract. 2021 Jan 27;33(12):1182-1189. doi: 10.1097/JXX.0000000000000533.
Prevalence of electronic health records (EHRs) has significantly increased, and EHRs are a known contributor to clinician burnout. However, it is unknown whether the use of multifunctional EHRs is associated with nurse practitioner (NP) burnout in primary care practices. This is a major gap in the literature because 69% of practicing NPs deliver primary care services to patients.
This study aimed to investigate whether the use of multifunctional EHRs is associated with primary care NP burnout.
This study is a secondary analysis of cross-sectional survey data collected from NPs in two states (Pennsylvania and New Jersey). Nurse practitioners completed surveys measuring burnout, use of multifunctional EHRs, demographics, and characteristics of their practice. Use of multifunctional EHRs was operationalized using two items-computerized capabilities and electronic reminder systems. Burnout was measured using a validated, single item asking NPs to self-report their feelings of burnout. A multilevel cox regression model was built to test for associations between the use of multifunctional EHRs and NP burnout.
Of 396 NPs included, 25.3% reported burnout. The use of multifunctional EHRs did not increase primary care NP burnout (risk ratio = 0.30, 95% confidence interval = 0.13-0.71, p = .01).
With 25.3% of NPs burned out, it is imperative to reduce NP burnout. However, computerized capabilities and electronic reminder systems did not contribute to feelings of NP burnout. Future research examining other EHR components is needed to understand which features of the EHR contribute to NP burnout.
电子健康记录(EHR)的普及率显著提高,EHR 是导致临床医生倦怠的已知因素。然而,尚不清楚多功能 EHR 的使用是否与初级保健实践中的护士从业者(NP)倦怠有关。这是文献中的一个主要空白,因为 69%的执业 NP 为患者提供初级保健服务。
本研究旨在调查多功能 EHR 的使用是否与初级保健 NP 倦怠有关。
本研究是对来自两个州(宾夕法尼亚州和新泽西州)的 NP 进行的横断面调查数据的二次分析。NP 完成了测量倦怠、多功能 EHR 使用、人口统计学和实践特征的调查。多功能 EHR 的使用通过两个项目来操作——计算机化功能和电子提醒系统。倦怠使用一个经过验证的单一项目来衡量,要求 NP 自我报告他们的倦怠感。建立了一个多层次 Cox 回归模型来测试多功能 EHR 使用与 NP 倦怠之间的关联。
在纳入的 396 名 NP 中,25.3%报告了倦怠。多功能 EHR 的使用并未增加初级保健 NP 的倦怠感(风险比=0.30,95%置信区间=0.13-0.71,p=0.01)。
由于 25.3%的 NP 倦怠,减少 NP 倦怠感势在必行。然而,计算机化功能和电子提醒系统并没有导致 NP 的倦怠感。需要进一步研究其他 EHR 组件,以了解 EHR 的哪些功能会导致 NP 倦怠。