Currently submitted to: JMIR Nursing
Date Submitted: Sep 24, 2026
Open Peer Review Period: Sep 25, 2026 - Nov 20, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
The Impact of Electronic Health Record on Registered Nurses’ Work in Emergency Department: A Pilot Qualitative Interview Study
ABSTRACT
Background:
Electronic Health Records are integral to Emergency Departments care, shaping how health care provider’s access information, communicate, and coordinate care.
Objective:
This qualitative pilot study examined, from nurses’ perspectives, how electronic health records implementation shaped nursing knowledge work and interdisciplinary roles within an urban Emergency Departments in Western Canada.
Methods:
Four registered nurses with 5-20 years of Emergency Departments experience participated in semi-structured interviews. Our study was informed by Translational Mobilization Theory and its focus on indirect nursing care and nursing knowledge as enacted through skillful manipulation of objects. Data were analyzed thematically to identify patterns related to nurses’ work, nursing knowledge, role adaptation, and workflow changes within the electronic health records supported Emergency Departments care environment.
Results:
Three themes were identified: (1) Nurses expected to maintain a coordination role in patient care with incomplete or delayed information, (2) Differential effects of electronic health records on nursing specific and interdisciplinary knowledge work, and (3) Clash between the electronic health records imposed conception of “patient safety” and nurses’ professional judgement.
Conclusions:
Findings suggest how electronic health records implementation actively reshapes nursing practice, including knowledge work, roles, and collaboration (as described by nurses), with implications for both practice and team dynamics, rather than simply digitizing existing workflows.
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