Andrew James E. Cordoba, Christine Joy C. Bringuelo, Owen Rayem A. Dela Cruz, Karen Florence A. Ismael, Jedidiah Shawn P. Jadloc, Jovielyn J. Marcos, Lauren Mae P. Oliver, Ashley Aine G. Palero, Dariella A. Tayrus, Sophia Gabrielle S. Ambrocio
Background: The increasing shift from paper-based documentation to electronic health record (EHR) systems in healthcare has significantly impacted clinical workflows, especially in outpatient departments. In the Philippines, limited studies have explored the learning curve and real-time adaptation experiences of nurses in these settings. This study was conducted to address this gap by understanding how nurses navigate the challenges of EHR implementation while maintaining quality patient care.
Methods: A descriptive qualitative research design was employed. Five registered nurses from a private hospital’s outpatient department were selected using criterion sampling. The inclusion criteria required that participants had at least 6 months of experience using the EHR system to ensure sufficient exposure to the adaptation process. Semi-structured interviews were conducted, transcribed, and analyzed using thematic analysis to identify patterns in adaptation experiences. Four major themes were identified: integrating digital tools into workflow, user efficiency, integrity and accessibility of records, and the role of healthcare professionals in EHR implementation.
Results: Four major themes emerged: (I) adapting and integrating digital tools within the clinical workflow; (II) exploring user efficiency and system proficiency in EHR use; (III) maintaining integrity and accessibility of electronic health records; and (IV) understanding the work of healthcare professionals in EHR implementation. Nurses highlighted both the benefits of digital systems such as faster documentation and improved coordination, and persistent challenges, including technical glitches, inadequate training, and digital literacy gaps, particularly among older staff. Informal support systems and self-initiated learning were crucial for overcoming these hurdles.
Conclusions: EHR implementation in outpatient nursing practice presents both promise and complexity. Successful adaptation depends not only on system infrastructure but also on human factors such as user training, peer support, and management responsiveness. These findings underscore the need for user-centered implementation strategies, continuous training programs, and institutional policies to improve EHR integration and support quality care.
