ORCID

0000-0002-1670-2272

Keywords

electronic health record, timeliness, nursing, perceptions, early warning system, vital signs

Abstract

Over the last 30 years, healthcare organizations have been implementing electronic health records (EHRs) to improve health performance and efficiency in workflow. EHR documentation remains burdensome, including vital sign capture and entry, and practices vary across acute care settings. Vital signs are a critical data element to identify patient deterioration. Vital sign entry into the EHR exists as either human-in-the-loop with manual data entry, device integrated entry with automatic upload from vital sign machines, or through continuous vital sign monitoring. When transitioning from manual to automated entry, data latency, errors, and clinician burden decrease while detection of patient deterioration improves due to immediate availability of vital sign data. Early warning systems (EWS), which are integrated into EHRs, use vital signs as key data elements to identify patient deterioration. Timely entry of vital signs is paramount for EWSs to trigger when patients decline. If patient deterioration is not detected, failure to rescue may occur leading to patient harm or death. Direct care nurses described barriers and facilitators to timely entry of vital signs into the EHR, as nurses are key to highlighting practice issues and opportunities for improvement. A Call-to-Action is being made for healthcare leaders, information technology developers, and nurse educators to support timely vital sign capture and EHR entry. Resources need to be reallocated to create human-centered technological environments that are easy for nurses to use and untether them from devices, which will protect both the well-being of the nursing workforce and the safety of the patients they serve.

Completion Date

2026

Semester

Spring

Committee Chair

Galura, Sandra

Degree

Doctor of Philosophy (Ph.D.)

College

College of Nursing

Department

Nursing Systems

Format

PDF

Document Type

Thesis

Identifier

DP0053138

Release Date

5-15-2028

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Available for download on Monday, May 15, 2028

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