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Electronic health record user mastery by nurses has seen a sharp decline since the beginning of the pandemic, according to researchers. 


Nearly 16,000 nurses across 35 healthcare organizations responded to a survey about their EHR experience. The results showed a significant drop with just 59% of nurses surveyed in 2022 finding ongoing training helpful compared to 71% of those surveyed in 2020. 

The urgency to build user mastery is clear, said KLAS researchers.

Nurses in radiology, pediatric and newborn intensive care units and procedural and behavioral health environments reported struggling with the EHR “and tend to disagree [that] their EHR has the functionality they need,” according to the guidebook.

Nurses in these areas would particularly benefit from improved onboarding, ongoing training, inclusion in governance and heightened communication efforts.

“Many would benefit from reevaluating how their training and education programs prepare nurses for their day-to-day EHR use while also weathering inevitable EHR and related environmental changes,” the researchers say.

The guidebook includes steps healthcare organizations can take to launch pilot programs to address EHR satisfaction and a series of evidence-based practice discussions with links to case studies for deploying best practices across three categories:

Communications and engagement strategy best practices covered include nursing representation in IT, use of superusers and governance and EHR changes.

Onboarding/initial EHR education best practice recommendations on training time, biaxin les effets secondaires content, trainer quality and training methods. 

Ongoing EHR education insights addressing frequency, IT rounding and use of virtual training. 

Chief among the engagement strategies are recommendations to include nurses in EHR governance and decision-making because organizations with multi-disciplinary teams see higher EHR satisfaction. Governance leaders should enable impacted nurses and other stakeholders to rate the expected effectiveness of proposed EHR changes.

Allowing frontline nurses to make EHR requests is also best practice, according to the guidebook.

“Organizations should focus on helping nurses get to the root problem and then work together with analysts to find a solution,” said researchers. “Doing this helps build relationships between IT personnel and nurses.”

This is the first Arch Collaborative Guidebook to focus exclusively on nursing professionals, according to a representative that reached out to Healthcare IT News. 


Last year, one study focused on nurse burnout published in the Journal of the American Medical Informatics Association had nurses grading EHR usability an F.

Many nurses are thinking about leaving the healthcare profession – and not just because of the staffing crisis hastened by the COVID-19 pandemic, according to Shawn Sefton, chief nursing officer and vice president of client services at Hospital IQ.

Sefton spoke with Healthcare IT News in March about a report that showed 90% of the surveyed nurses saying they plan to leave the profession.

“Given the breadth of the current healthcare staff crisis in this country, the results were both alarming and illuminating,” said Sefton. 

One cause is that nurses want healthcare systems to streamline and automate manual workflows.

“Outdated, inefficient and manual workflows and communications processes consume too much of nurses’ time and attention, and make it nearly impossible to achieve effective and efficient coordination of care across units and teams,” Sefton had said.


“Nurses should have a chance to make mistakes in a safe environment and learn how to respond to some of the more challenging documentation issues that may arise in their given work area,” the KLAS Arch Collaborative guidebook advises.

“While nurse satisfaction with the EHR is likely not the largest driver of burnout and job satisfaction, it does appear to be a very important part of a nurses’ overall job satisfaction. We continue to see strong associations between EHR satisfaction, satisfaction with EHR training and an individual’s self-reported burnout levels and potential turnover,” said report author Jacob Jeppson, data scientist for the Arch Collaborative. 

Andrea Fox is senior editor of Healthcare IT News.
Email: [email protected]

Healthcare IT News is a HIMSS publication.

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