With the prodding of new federal legislation, electronic health records (EHRs) are rapidly becoming part of the daily practice of hospital nurses -- the frontline providers of care. In the first large study of its kind, researchers at the University of Pennsylvania School of Nursing determined that nurses working with EHRs consistently reported more improvements to nursing care and better health outcomes for patients than nurses working in hospitals without this technology.

A study of more than 16,000 nurses working at 316 hospitals in four states indicates that "implementation of an EHR may result in improved and more efficient nursing care, better care coordination, and patient safety," wrote lead author Ann Kutney-Lee, PhD, RN, a health outcomes researcher at Penn Nursing, in the Journal of Nursing Administration. Her co-author is Penn Nursing fellow Deena Kelly, RN.

At the same time, the authors wrote, "it is important to note that having a basic EHR was associated with better outcomes independently of nurse staffing, indicating that they both play an important role in quality of care."

Nurses in hospitals with fully implemented basic EHRs were significantly less likely to report unfavorable patient safety issues, frequent medication errors, and low quality of care. These findings suggest that the level of detail available in the EHR may allow for more comprehensive unit transfer reports and discharge summaries to outside healthcare providers.

Recent estimates report that only 12 percent of U.S. hospitals have a basic EHR system in place, but that is likely to change under the Health Information Technology for Economic and Clinical Health (HITECH) Act. Beginning in 2011 under HITECH, Medicare and Medicaid began to offer federal incentive payments of $2 million or more to healthcare providers and hospitals to use EHR technologies.

"With the passage of the HITECH Act," said Dr. Kutney-Lee, "EHRs are rapidly becoming part of the daily practice of the bedside nurse. Nursing administrators should be fully engaged in the process of EHR adoption and implementation to ensure effective use and success in creating seamless transitions for patients throughout the healthcare continuum. The degree of support from nurse leaders for the EHR will affect the success of this technology's implementation and, as a result, patient care."