Nurses' Perceptions of Facilitators and Barriers to Their Acceptance of Electronic Health Records: A Mixed-Method Systematic Review

Background: International eHealth strategies incorporate the adoption of electronic health records to enhance the delivery of integrated healthcare and improve patient outcomes. Nurses’ acceptance of electronic health records is crucial for their successful implementation. Aim: To synthesise evidence from empirical studies to explore the nurses' perceptions of facilitators and barriers and the influence of moderating factors on their acceptance of electronic health records. Design: A convergent integrated mixed-method systematic review following the JBI methodology. Data Sources: CINAHL Plus with Full Text, Medline [EBSCO], ProQuest, PubMed, Scopus, Google Scholar and Open Grey were searched on 28 March 2023 for primary research studies published between 2018 and 2023. Review Methods: Studies were screened by two independent reviewers adhering to predetermined inclusion criteria. A convergent integrated synthesis was conducted and deductive analysis was framed by The Unified Theory of Acceptance and Use of Technology model. Results: Thirteen studies were included and appraised using the mixed-method appraisal tool. Facilitators of nurses' acceptance of electronic health records included increased efficiency, improved access to information, management support and training. Nurses identified increased documentation burden, threats to patient confidentiality, difficult navigation and inadequate IT support and training as barriers to their acceptance. The influence of moderators on nurses' acceptance of electronic health records remains unclear. Conclusion: This review provides insights into nurses' perceptions of factors influencing electronic health record acceptance. Addressing these issues during adoption and further exploring the impact of moderators can improve acceptance and minimise unintended consequences. Implications: Nurse leaders are key in empowering nurses to accept electronic health records. The nursing profession must participate in all phases of electronic health record design and implementation to ensure that they complement nursing practice. Reporting Method: PRISMA 2020 Statement. No Patient or Publication Contribution: This is a review of primary research.