Factors influencing the use of electronic health records among nurses in a teaching hospital in Nigeria

Background: Effective use of Electronic Health Records (EHR) by healthcare professionals has great potentials of optimizing the process of healthcare service delivery, especially in clinical sites. Despite high potentials for transformation of healthcare services through implementation of EHR as the core driver of prompt access, timely interventions, evidence-based decision making, cost-effective care, efficient management of scarce resources and client satisfaction; some EHR projects had fallen short of fulfilling these critical objectives. In recent past, factors ranging from human to socio-technical issues have been reported as determinants of use and non-use of EHR among target professionals. Therefore, this study investigated knowledge of EHR, access to electronic recording devices, awareness of an EHR named Made-In-Nigeria Primary Healthcare and Hospital Information System (MINPHIS), utilization of MINPHIS, and perceived factors responsible for use or non-use of MINPHIS among nurses in a teaching hospital in Nigeria. The nurse-user, institutional and societal related factors influencing utilization of MINPHIS in the pioneering teaching hospital was determined. Methods: A cross-sectional design was used to collect quantitative data using a structured questionnaire among nurses working in the teaching hospital of reference. Systematic random sampling was used to select 230 nurses, out of which 206 consented. Data analysis was done using SPSS version 17. Hypotheses were tested at p value < 0.05 using Chi square and correlation coefficient. Results: Majority of nurses (80.1%) had never used MINPHIS despite a significant percentage (79.6%) willing to use electronic health records. Only 37.4% claimed they were provided with MINPHIS computer system in their workplace, while 86.9% had never been trained. 26 of the 27 nurses that were trained claimed it lasted for few days while 25 affirmed it had no impact on use of MINPHIS. Consequently, 93.7% emphasized that paper documentation remained dominant. Statistically, there was significant relationship between use of the EHR (MINPHIS) and age (p = 0.045), years of working experience (p = 0.007), availability of computer system (p = 0.000), and training of users (p = 0.000). Conclusion: Nurses are willing to use Electronic Health Record system but the required practical on-the-job training, necessary equipment and enabling environment are not supportive of the reported interest. All factors, user-related, institutional and societal factors, need to be appropriately examined and supported for successful use of EHR for improved healthcare delivery in Nigeria and similar developing countries. Implication: Future researches should adopt a multi-level approach (i.e. individual, institutional and societal) in evaluating factors that may influence successful implementation of EHR projects among target users.