Nurses unsure whether NHS can deliver EPRs

Over half of nurses do not believe or do not know whether the NHS can deliver an electronic patient record (EPR) in the foreseeable future, according to a new survey from the Royal College of Nursing (RCN).

The RCN survey, carried out online by Medix Intelligent Information, also found that familiar problems persist in relation to consultation about the development of electronic record ands access to computers at work.

The 2007 survey, the fourth year running the RCN has polled nurses on IT, shows two thirds of nurses reporting that they have not been consulted about the introduction of the new record or the information that will be entered on it. This figure is unchanged from a similar survey carried out in 2004, which found 63% had not been involved in the new system’s design or development.

The survey, with 2,600 respondents, also found almost two-thirds of nursing staff had not received any IT training within the last six months. Nearly half (45%) have to share a computer at work with more than five people and 16% of nurses say they share a computer with more than 20 people.

RCN general-secretary, Dr Peter Carter commented: “This survey shows IT training programmes for health service staff and the number of computers available for them to use will have to be expanded on a significant scale in the next two to three years if electronic records are going to support and not hinder clinical care.

“We know from anecdotal evidence that some nurses are uncomfortable and perhaps even reluctant to use computers. This problem is perpetuated by there not being enough machines in clinical settings and not enough staff on the wards and in the community to provide cover for those who need to be released for support and training.

“We cannot have a situation where nursing staff are waiting in line with 20 or more people for time on a computer to carry out essential documentation. Equally, we cannot have a system that is dependent on so few computers to facilitate care.”

Despite the problems, the profession remains broadly supportive of IT modernisation. The survey found two-thirds of nurses (66%) welcome the introduction of an EPR, a figure that rose to 76% among nurses with experience of electronic records.

Prior experience of electronic records did not necessarily translate into in a belief that the records will benefit patients, however. For example, 30% of nurses who had used EPRs did not agree that electronic systems were more secure than paper-based systems. 42% said the new records would not save nursing time.

The survey report concludes that there continues to be a high degree of uncertainty about the impact the record will have on patient care, safety and confidentiality.

Dr Carter commented: "This survey shows that progress on IT has been made in some areas and it is positive to see that, despite some adverse coverage in the media, nurses on the whole remain supportive of the concept of an electronic record.

“However, on the important issues of consultation and engagement, nurses are saying little has changed in the past four years and that is disappointing considering where we are with the programme.

“The health service has a challenging time ahead if it wants nurses to be ready for the new software, which will have a positive impact on professional practice and the contact nurses have with patients.

“If electronic patient records are to be introduced in the right way with staff fully engaged and involved, the health service has to get to grips with this problem before it is too late.”