Infrastructural and Training Barriers to Electronic Medical Record Use Among Nurses at Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, Nigeria
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Abstract
Background: Electronic Medical Records can improve nursing practice, but effective use depends on overcoming infrastructural and organizational challenges which are severe in resource limited Nigeria.
Objective: To identify perceived EMR challenges among nurses at Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria.
Methods: This descriptive cross-sectional study involved registered nurses selected via stratified random sampling. The sample size (248) was calculated using the Taro Yamane formula. Of 248 questionnaires distributed, 231 were completed and returned (response rate: 93.1%). Data were collected using a structured, self-administered 15-item questionnaire rated on a 5-point Likert scale. The instrument showed good internal consistency (Cronbach's α = 0.85). Mean scores of 3.50 or higher indicated agreement with a challenge.
Results: Most significant challenges were: insufficient computer workstations (mean = 3.71, SD = 1.23; 68.4%), lack of internet connectivity (mean = 3.61, SD = 1.12; 64.5%), frequent system downtime (mean = 3.60, SD = 1.10; 63.2%), insufficient ongoing training (mean = 3.51, SD = 1.14; 58.9%) and data security concerns (mean = 3.50, SD = 1.23; 57.6%). Participants disagreed that the system was not user-friendly (mean = 2.25; 68.0%) and colleagues were unsupportive (mean = 2.02; 74.5%). The remaining eight items fell within the neutral range (2.50–3.49), though percentage agreements revealed substantial heterogeneity in experiences.
Conclusion: Significant infrastructural and training-related barriers persist. Inadequate hardware, unreliable internet, system downtime, insufficient ongoing training and data security concerns are the primary obstacles to optimal EMR use. Hospital administration should prioritize increasing computer workstations, ensuring internet redundancy, implementing quarterly refresher training, and strengthening data security protocols.
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