TY - JOUR
T1 - How does implementation of an electronic medical record system impact nurses' work motivation, engagement, satisfaction and well-being? A realist review protocol
AU - Jedwab, Rebecca M.
AU - Redley, Bernice
AU - Manias, Elizabeth
AU - Dobroff, Naomi
AU - Hutchinson, Alison M.
N1 - Funding Information:
Funding This work was supported by an Australian Government Research Training Programme Scholarship.
Publisher Copyright:
© 2021 BMJ Publishing Group. All rights reserved.
PY - 2021/10
Y1 - 2021/10
N2 - Introduction Electronic medical record (EMR) systems are used worldwide as repositories for patients' clinical information, providing clinical decision support and increasing visibility of and access to clinical information. While EMR systems facilitate improved healthcare delivery, emerging reports suggest potential detrimental effects on clinician well-being. EMR system implementation influences on nurses' work motivation, engagement, satisfaction and well-being (including burnout) are not well understood, nor have they been examined in relation to contextual factors and mechanisms of action. This paper presents a realist review protocol to examine causal explanations to address the question: How, why and under what circumstances does the implementation of a new hospital EMR system or similar technology impact nurses' work motivation, engagement, satisfaction or well-being? Methods and analysis The five-step method for realist review will be used to identify causal relationships, how the relationships work, for whom and under what circumstances: (1) defining the review scope; (2) developing initial program theories; (3) searching the evidence; (4) selecting and appraising the evidence; (5) extracting and synthesising the data. Initial program theories were developed using scoping review findings and qualitative data collected from nurses pre-EMR and post-EMR. Five databases will be systematically searched from 1 January 2000 to 31 October 2021 (APA PsycInfo, CINAHL, Embase, IEEE Xplore and MEDLINE Complete), and forward and backward citation searching, grey literature searching and literature recommended by the research team. Search results will be screened by two research team members. Data extracted will assist in refining program theories to develop a conceptual model that synthesises how work motivation, engagement, satisfaction and well-being may influence, or be influenced by, an EMR implementation. Ethics and dissemination The larger project has previously obtained low-risk ethics approval. The review will be published in a peer-reviewed journal and reported as per RAMESES guidelines. PROSPERO registration number CRD42020131875.
AB - Introduction Electronic medical record (EMR) systems are used worldwide as repositories for patients' clinical information, providing clinical decision support and increasing visibility of and access to clinical information. While EMR systems facilitate improved healthcare delivery, emerging reports suggest potential detrimental effects on clinician well-being. EMR system implementation influences on nurses' work motivation, engagement, satisfaction and well-being (including burnout) are not well understood, nor have they been examined in relation to contextual factors and mechanisms of action. This paper presents a realist review protocol to examine causal explanations to address the question: How, why and under what circumstances does the implementation of a new hospital EMR system or similar technology impact nurses' work motivation, engagement, satisfaction or well-being? Methods and analysis The five-step method for realist review will be used to identify causal relationships, how the relationships work, for whom and under what circumstances: (1) defining the review scope; (2) developing initial program theories; (3) searching the evidence; (4) selecting and appraising the evidence; (5) extracting and synthesising the data. Initial program theories were developed using scoping review findings and qualitative data collected from nurses pre-EMR and post-EMR. Five databases will be systematically searched from 1 January 2000 to 31 October 2021 (APA PsycInfo, CINAHL, Embase, IEEE Xplore and MEDLINE Complete), and forward and backward citation searching, grey literature searching and literature recommended by the research team. Search results will be screened by two research team members. Data extracted will assist in refining program theories to develop a conceptual model that synthesises how work motivation, engagement, satisfaction and well-being may influence, or be influenced by, an EMR implementation. Ethics and dissemination The larger project has previously obtained low-risk ethics approval. The review will be published in a peer-reviewed journal and reported as per RAMESES guidelines. PROSPERO registration number CRD42020131875.
KW - change management
KW - health informatics
KW - protocols & guidelines
UR - http://www.scopus.com/inward/record.url?scp=85117122986&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2021-055847
DO - 10.1136/bmjopen-2021-055847
M3 - Review Article
C2 - 34620677
AN - SCOPUS:85117122986
SN - 2044-6055
VL - 11
JO - BMJ Open
JF - BMJ Open
IS - 10
M1 - e055847
ER -