Burnout Syndrome in the Era of Electronic Health Records: A Scoping Review
Palabras clave:
nursing, professional exhaustion, electronic health records, health information systems, health personnel.Resumen
Burnout Syndrome is characterized as a psychosocial phenomenon, resulting from the inability to adapt and cope with stressors to which the professional is exposed. The use of technological innovations such as the Electronic Health Record has been associated as one of the potential factors for Burnout Syndrome. To analyze the scientific evidence on Burnout Syndrome in Electronic Health Records use. This is a scoping review study conducted in the PubMed, Scopus, Embase, WoS and Cochrane databases. Data collection took place in February and March 2021 using the following descriptors: Burnout, Electronic Health Records, Health Information Systems, Occupational Burnout, Professional, Psychological Distress. Of the 996 studies found, 44 were selected for full reading, of which 21 articles made up the final sample. The studied population was predominantly made up of nurses and doctors who worked in primary care and hospitals. It was observed that exhaustion, stress, emotional exhaustion, dissatisfaction and depersonalization were the most predominant stressors related to the use of Electronic Health Records. Regarding the level of evidence of the articles, 95% of them presented level IV and only 5% level III. Electronic Health Records have contributed more agility and efficiency to their users, although there are still divergent points that need to be reviewed in order to help reduce physical and mental exhaustion in nurses and physicians as a result of this software.
Citas
Kaipio J, Kuusisto A, Hyppönen H, Heponiemi T, Lääveri T. Physicians' and nurses' experiences on EHR usability: Comparison between the professional groups by employment sector and system brand. Int J Med Inform. 2020;134:104018. DOI: https://doi.org/10.1016/j.ijmedinf.2019.104018
Kruse CS, Stein A, Thomas H, Kaur H. The use of electronic health records to support population health: A systematic review of the literature. J Med Syst. 2018;42(11):214. DOI: https://doi.org/10.1007/s10916-018-1075-6
Lima VS; Lima VS; Vale TM, Pisa IT. Prontuário eletrônico do cidadão: desafios e superações no processo de informatização. Re Saúd Digi Tec Edu. 2018;3(ed. esp.):100-13. Available from: http://periodicos.ufc.br/resdite/article/view/39756
Guimarães EAA, Morato YC, Carvalho DBF, Oliveira VC, Pivatti VMS, Cavalcante RB, Gontijo TL, Dias TMR. Evaluation of the usability of the immunization information system in Brazil: A mixed-method study. Telemed J E Health. 2021;27(5):551-60. DOI: https://doi.org/10.1089/tmj.2020.0077
Oliveira VC, Guimarães EAA, Perez G, Zacharias FCM, Cavalcante RB, Gontijo TL, et al. Factors related to the adoption of the Brazilian National Immunization Program Information System. BMC Health Serv Res. 2020;20(1):759. DOI: https://doi.org/10.1186/s12913-020-05631-6
Oliveira VC, Guimarães EAA, Amaral GG, Silva TIM, Fabriz LA, Pinto IC. Acceptance and use of the Information System of the National Immunization Program. Rev Lat Am Enfermagem. 2020;28:e3307. DOI: https://doi.org/10.1590/1518-8345.3360.3307
Silva BS, Guimarães EAA, Oliveira VC, Cavalcante RB, Pinheiro MMK, Gontijo TL, et al. National Immunization Program Information System: implementation context assessment. BMC Health Serv Res. 2020;20(1):333. DOI: https://doi.org/10.1186/s12913-020-05175-9
Namageyo-Funa A, Aketch M, Tabu C, MacNeil A, Bloland P. Assessment of select electronic health information systems that support immunization data capture - Kenya, 2017. BMC Health Serv Res. 2018;18(1):621. DOI: https://doi.org/10.1186/s12913-018-3435-9
Alsohime F, Temsah MH, Al-Eyadhy A, Bashiri FA, Househ M, Jamal A, et al. Satisfaction and perceived usefulness with newly-implemented Electronic Health Records System among pediatricians at a university hospital. Comput Methods Programs Biomed. 2019;169:51-7. DOI: https://doi.org/10.1016/j.cmpb.2018.12.026
Domaney NM, Torous J, Greenberg WE. Exploring the Association between electronic health record use and burnout among psychiatry residents and faculty: a Pilot survey study. Acad Psychiatry. 2018;42(5):648-52. DOI: https://doi.org/10.1007/s40596-018-0939-x
Vehko T, Hyppönen H, Ptonen S, Kujala S, Ketola E, Tuukkanen J, Aalto AM, Heponiemi T. Experienced time pressure and stress: electronic health records usability and information technology competence play a role. BMC Med Inform Decis Mak. 2019;19(1):160. DOI: https://doi.org/10.1186/s12911-019-0891-z
Williams ES, Rathert C, Buttigieg SC. The personal and professional consequences of physician burnout: A systematic review of the literature. Med Care Res Rev. 2020;77(5):371-86. DOI: https://doi.org/10.1177/1077558719856787
West CP, Dyrbye LN, Shanafelt TD. Physician burnout: contributors, consequences and solutions. J Intern Med. 2018;283(6):516-29. DOI: https://doi.org/10.1111/joim.12752
Vanderhook S, Abraham J. Unintended consequences of EHR systems: a narrative review. In: Proceedings of the International Symposium on Human Factors and Ergonomics in Health Care. Los Angeles: SAGE Publications; 2017. p. 218-22.
Shanafelt TD, Dyrbye LN, Sinsky C, Hasan O, Satele D, Sloan J, et al. Relationship between clerical burden and characteristics of the electronic environment with physician burnout and professional satisfaction. Mayo Clin Proc. 2016;91(7):836-48. DOI: https://doi.org/10.1016/j.mayocp.2016.05.007
Attipoe S, Huang Y, Schweikhart S, Rust S, Hoffman J, Lin S. Factors associated with electronic health record usage among primary care physicians after hours: Retrospective cohort study. JMIR Hum Factors. 2019;6(3):e13779. DOI: https://doi.org/10.2196/13779
Saag HS, Shah K, Jones SA, Testa PA, Horwitz LI. Pajama time: Working after work in the electronic health record. J Gen Intern Med. 2019;34(9):1695-96. DOI: https://doi.org/10.1007/s11606-019-05055-x
Kroth PJ, Morioka-Douglas N, Veres S, Pollock K, Babbott S, Poplau S, et al. The electronic elephant in the room: Physicians and the electronic health record. JAMIA Open. 2018 Jul;1(1):49-56. DOI: https://doi.org/10.1093/jamiaopen/ooy016
Arndt BG, Beasley JW, Watkinson MD, Temte JL, Tuan WJ, Sinsky CA, et al. Tethered to the EHR: primary care physician workload assessment using EHR event log data and time-motion observations. Ann Fam Med. 2017;15(5):419-26. DOI: https://doi.org/10.1370/afm.2121
Ehrenfeld JM, Wanderer JP. Technology as friend or foe? Do electronic health records increase burnout? Curr Opin Anaesthesiol. 2018;31(3):357-60. DOI: https://doi.org/10.1097/ACO.0000000000000588
Gesner E, Gazarian P, Dykes P. The burden and burnout in documenting patient care: An integrative literature review. Stud Health Technol Inform. 2019;264:1194-98. DOI: https://doi.org/10.3233/SHTI190415
Kroth PJ, Morioka-Douglas N, Veres S, Babbott S, Poplau S, Qeadan F, et al. Association of electronic health record design and use factors with clinician stress and burnout. JAMA Netw Open. 2019;2(8):e199609. DOI: https://doi.org/10.1001/jamanetworkopen.2019.9609
Flanagan ME, Militello LG, Rattray NA, Cottingham AH, Frankel RM. The thrill is gone: Burdensome Electronic documentation takes its toll on physicians' time and attention. J Gen Intern Med. 2019;34(7):1096-7. DOI: https://doi.org/10.1007/s11606-019-04898-8
Adler-Milstein J, Zhao W, Willard-Grace R, Knox M, Grumbach K. Electronic health records and burnout: Time spent on the electronic health record after hours and message volume associated with exhaustion but not with cynicism among primary care clinicians. J Am Med Inform Assoc. 2020;27(4):531-8. DOI: https://doi.org/10.1093/jamia/ocz220
Melnick ER, Dyrbye LN, Sinsky CA, Trockel M, West CP, Nedelec L, et al. The association between perceived electronic health record usability and professional burnout among US physicians. Mayo Clin Proc. 2020;95(3):476-87. DOI: https://doi.org/10.1016/j.mayocp.2019.09.024
Tricco AC, Lillie E, Zarin W, O'Brien KK, Colquhoun H, Levac D, et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and explanation. Ann Intern Med. 2018;169(7):467-73. DOI: https://doi.org/10.7326/M18-0850
Peters MDJ, Godfrey CM, McInerney P, Soares CB, Khalil, Parker D. Methodology for JBI scoping reviews. Adelaide: The Joanna Briggs Institute Reviewers Manual; 2015.
Melnyk BM, Fineout-Overholt E. Evidence-based practice in nursing & healthcare: A guide to best practice. Philadelphia: Lippincott Williams & Wilkins; 2011.
Mendes KDS, Silveira RCCP, Galvão CM. Revisão integrativa: método de pesquisa para a incorporação de evidências na saúde e na enfermagem. Texto & Contexto Enferm. 2008;17(4):758-64. DOI: https://doi.org/10.1590/S0104-07072008000400018
BRASIL. Ministério da Saúde. Conselho Nacional de Saúde. Comissão Nacional de Ética em Pesquisa. Resolução n.o 466, de 12 de dezembro de 2012. Brasília: Ministério da Saúde; 2012.
Associação Brasileira de Normas Técnicas. NBR ISO/IEC 29110: Engenharia de software qualidade de produto. Rio de Janeiro: ABNT; 2011 [access 08/04/2022]. Available from: http://www.abntcatalogo.com.br/norma.aspx?ID=002815
Brooke J. SUS: A “quick and dirty” usability scale. In: Jordan PW, Thomas B, Weerdmeester BA, McClelland IL (editors). Usability Evaluation in Industry. London: Taylor and Francis; 1996.
Hilliard RW, Haskell J, Gardner RL. Are specific elements of electronic health record use associated with clinician burnout more than others? J Am Med Inform Assoc. 2020;27(9):1401-10. DOI: https://doi.org/10.1093/jamia/ocaa092
Gregory ME, Russo E, Singh H. Electronic health record alert-related workload as a predictor of burnout in primary care providers. Appl Clin Inform. 2017;8(3):686-97. DOI: https://doi.org/10.4338/ACI-2017-01-RA-0003
Tai-Seale M, Dillon EC, Yang Y, Nordgren R, Steinberg RL, Nauenberg T, et al. Physicians' well-being linked to in-basket messages generated by algorithms in electronic health records. Health Aff. 2019;38(7):1073-8. DOI: https://doi.org/10.1377/hlthaff.2018.05509
Tran B, Lenhart A, Ross R, Dorr DA. Burnout and EHR use among academic primary care physicians with varied clinical workloads. AMIA Jt Summits Transl Sci Proc. 2019;2019:136-44. Available from: https://pubmed.ncbi.nlm.nih.gov/31258965/
Tajirian T, Stergiopoulos V, Strudwick G, Sequeira L, Sanches M, Kemp J, et al. The Influence of electronic health record use on physician burnout: Cross-Sectional survey. J Med Internet Res. 2020;22(7):e19274. DOI: https://doi.org/10.2196/19274
Gardner RL, Cooper E, Haskell J, Harris DA, Poplau S, Kroth PJ, et al. Physician stress and burnout: the impact of health information technology. J Am Med Inform Assoc. 2019;26(2):106-114. DOI: https://doi.org/10.1093/jamia/ocy145
Harris DA, Haskell J, Cooper E, Crouse N, Gardner R. Estimating the association between burnout and electronic health record-related stress among advanced practice registered nurses. Appl Nurs Res. 2018;43:36-41. DOI: https://doi.org/10.1016/j.apnr.2018.06.014
Kaihlanen AM, Gluschkoff K, Hyppönen H, Kaipio J, Puttonen S, Vehko T, et al. The associations of electronic health record usability and User age with stress and cognitive failures among finnish registered nurses: Cross-sectional Study. JMIR Med Inform. 2020;8(11):e23623. DOI: https://doi.org/10.2196/23623
Collins S, Couture B, Kang MJ, Dykes P, Schnock K, Knaplund C, et al. Quantifying and visualizing nursing flowsheet documentation burden in acute and critical care. AMIA Annu Symp Proc. 2018;2018:348-57. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6371331/
Santos CMC, Pimenta CAM, Nobre MRC. A estratégia PICO para a construção da pergunta de pesquisa e busca de evidências. Rev Latino-Am Enferm. 2007;15(3):508-11. DOI: https://doi.org/10.1590/S0104-11692007000300023
Descargas
Publicado
Cómo citar
Número
Sección
Licencia
Aquellos autores que tengan publicaciones con esta revista, aceptan los términos siguientes:
- Los autores conservarán sus derechos de autor y garantizarán a la revista el derecho de primera publicación de su obra, el cuál estará simultáneamente sujeto a la Licencia Atribución-NoComercial 4.0 Internacional (CC BY-NC 4.0) que permite a terceros compartir la obra siempre que se indique su autor y su primera publicación esta revista.
- Los autores podrán adoptar otros acuerdos de licencia no exclusiva de distribución de la versión de la obra publicada (p. ej.: depositarla en un repositorio institucional o publicarla en un volumen monográfico) siempre que se indique la publicación inicial en esta revista.
- Se permite y recomienda a los autores difundir su obra a través de Internet (p. ej.: en repositorios institucionales o en su página web) antes y durante el proceso de envío, lo cual puede producir intercambios interesantes y aumentar las citas de la obra publicada. (Véase El efecto del acceso abierto). En ese caso, solicitamos que en la cabecera del manuscrito se indique:"Esta es una versión preprint enviada a la Revista Cubana de Información en Ciencias de la Salud http://rcics.sld.cu/"
ENGLISH VERSION
AUTHORS WITH PUBLICATIONS IN THIS JOURNAL ACCEPT THE FOLLOWING TERMS:
- Authors will retain their copyright and will grant the Journal the right of first publication of their work, which will also be subject to a Creative Commons License Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) allowing third parties to share the work as long as the author's name and data about initial publication in this Journal are stated.
- Authors may adopt other license agreements for non-exclusive distribution of the version of the work published (e.g. deposit it in an institutional repository or publish it in a monographic volume), as long as initial publication in this Journal is indicated.
- It is permitted and recommended for authors to disseminate their work on the Internet (e.g. in institutional repositories or their web page) before and during the submission process, which may result in interesting exchanges and increase the number of citations of the published work) (see The effect of open access).
