BACKGROUND
Mobile devices such as tablets and smartphones are increasingly used in health care in many developed countries. Nurses form the largest group in health care that uses electronic health records (EHRs) and their mobile versions. Mobile devices are suggested to promote nurses’ workflow, constant updating of patient information and improve the communication within the health care team. However, little is known about their effect on nurses’ wellbeing.
OBJECTIVE
The present study aimed to examine the association of mobile device use of the EHR with nurses’ perceived time pressure, stress related to information systems (SRIS) and self-rated stress. Moreover, we examined whether mobile device use modifies the associations of EHR usability (ease of use and technical quality), experience in using EHRs and number of systems in daily use with these wellbeing indicators.
METHODS
The present study was a cross-sectional population-based survey study among 3,610 Finnish registered nurses gathered in 2020. The associations were examined using analyses of covariance and logistic regression adjusted for age, gender and employment sector (hospital, primary care, social service and other).
RESULTS
Those who used mobile version of their EHR had higher levels of time pressure ( F(1)= 14.96, p < .001) and SRIS ( F(1)= 6.11, p = .01) compared to those who did not use mobile versions. Moreover, the interactions of mobile device use with experience in using EHRs (F(1) = 14.93, p < .001), ease of use (F(1) = 10.16, p = .001) and technical quality (F(1) = 6.45, p = .01) were significant for SRIS. Inexperience in using EHRs, low levels of ease of use and technical quality were associated with higher SRIS and this association was more pronounced among those who used mobile devices. That is, the highest levels of SRIS were perceived among those who used mobile devices and were inexperienced EHR users, perceived low levels of ease of use or low levels of technical quality of their EHR.
CONCLUSIONS
According to our results it seems that at the moment mobile device use is not beneficial for the nurses’ wellbeing. In addition, mobile device use seems to intensify the negative effects of usability problems of the EHRs. Especially inexperienced users of EHRs seem be at disadvantage when using mobile devices. Thus, we suggest that EHRs and their mobile versions should be improved in a manner that they would be easier to use and would better support the nurses’ workflow. For example, improvements to problems related to small display, user interface and difficult data entry of mobile versions might be useful. Moreover, more training related to EHRs, their mobile versions and workflow related to these should be provided to nurses.