Electronic health records are helping nurses provide better care, big study finds

Electronic health records are helping nurses get better health outcomes and are improving nursing care, the first big study on the subject has found.

The study conducted by the University of Pennsylvania School of Nursing involved 16,000 nurses at 316 hospitals in California, Florida, Pennsylvania and New Jersey. It found 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, a health-outcomes researcher at Penn Nursing.

The study, which was published in the Journal of Nursing Administration, also found, "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 that had comprehensive EHR systems were "significantly less likely to report unfavorable patient safety issues, frequent medication errors, and low quality of care," research-reporting service Newswise reports.

The most current estimates show just 12 percent of U.S. hospitals have an EHR system in place, but that will change with the Health Information Technology for Economic and Clinical Health Act. Starting in 2011, hospitals and physicians received incentive payments from Medicare and Medicaid to switch over to EHRs. The study did not measure outcomes in rural vs. urban settings "although we do know from other studies that hospitals that used electronic health records during this time period were less likely to be in rural areas," Kutney-Lee said. (Read more)

Nurse practitioners endorse new plan to fight prescription drug abuse, ask to be on board that will recommend standards

UPDATE, Oct. 14: Gov. Steve Beshear's executive order did not create a slot for advance-practice registered nurses on the advisory council, which will have representatives appointed by Beshear and nominated by the Kentucky Board of Medical Licensure, the Kentucky Board of Dentistry, the Kentucky Board of Nursing and the Kentucky Board of Pharmacists. "The medical licensure boards will send the governor a list of nominees for the slots on the advisory council, and the governor will name the full council within the next few weeks," a release from Beshear's office said.

The Kentucky Coalition of Nurse Practitioners and Nurse Midwives is endorsing the plan announced Thursday by state officials to fight prescription drug abuse, but asking that advance-practice registered nurses (APRNs) who prescribe controlled substances be added to the advisory board that will set standards for over-prescribing.

“We believe that the addition of APRNs who are prescribing controlled substances for different populations will be very helpful . . . in creating guidelines for generally accepted practices,” Julianne Ewen, president of the 2,049-member coalition, said in the release, available here.

Advance practice registered nurses may prescribe controlled substances within certain limits. Wendy Fletcher, past president of the coalition, noted that APRNs make up 9.9 percent of all prescribers in Kentucky but prescribe only 3.7 percent of controlled-substance prescriptions in the state and “have demonstrated that they are responsible prescribers.”

While fewer than a third of Kentucky doctors use the Kentucky All Schedule Prescription Electronic Reporting database, "APRNs who prescribe controlled substances have eagerly made use of the KASPER tracking system," the release said. The coalition wants the legislature to require that all APRNs who have a Drug Enforcement Agency number register for a KASPER account.