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Egyptian Pediatric Association Gazette
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The role of electronic health records in improving pediatric nursing care: a systematic review

Egyptian Pediatric Association Gazette volume 72, Article number: 77 (2024) Cite this article

Abstract

Background

The adoption of electronic health records (EHRs) has revolutionized healthcare delivery, offering potential benefits for enhancing the quality and safety of pediatric nursing care. However, the effective implementation and utilization of EHRs in pediatric settings present unique challenges.

Objectives

This systematic review aims to critically analyze the available literature on the role of EHRs in improving various aspects of pediatric nursing care, including clinical documentation, medication management, care coordination, and patient engagement.

Methods

A comprehensive search of multiple electronic databases (PubMed, CINAHL, Embase, and Cochrane Library) was conducted to identify relevant studies published between January 2000 and March 2023. Eligible studies included randomized controlled trials (RCTs), observational studies, and qualitative research investigating the impact of EHRs on pediatric nursing care outcomes. Study selection, data extraction, and quality assessment were performed by two independent reviewers.

Results

Out of 1,257 records, 28 studies (12 RCTs, 10 observational, 6 qualitative) were included, involving 3,642 pediatric patients and 1,278 healthcare professionals. EHRs were associated with a 20% improvement in clinical documentation completeness. However, initial implementation was associated with increased documentation time. EHRs with computerized provider order entry (CPOE) reduced medication errors by 30%, but initial training challenges were noted. Redundant testing was reduced by 15%, and care continuity improved by 25% with EHR implementation. Key themes from qualitative research included increased patient involvement in care decisions and improved satisfaction with care processes.

Conclusion

EHRs have the potential to enhance various aspects of pediatric nursing care, including improved documentation, medication management, care coordination, and patient engagement. Nonetheless, successful implementation requires addressing system usability, interoperability, and user acceptance through comprehensive training, workflow redesign, and ongoing technical support.

Systematic review registration 

This review was registered with PROSPERO (CRD42024563092).

Summary points

  1. 1.

    What was already known on the topic? EHRs have been increasingly implemented in healthcare settings, with recognized benefits for clinical documentation and care coordination.

  2. 2.

    What this study adds to our knowledge? This study provides a focused synthesis of the specific impacts of EHRs on pediatric nursing care, offering evidence-based insights into improved clinical outcomes and patient engagement strategies.

Background

Ensuring the delivery of high-quality, safe, and efficient pediatric nursing care remains a global healthcare priority. Electronic Health Records (EHRs) have emerged as pivotal tools in supporting this endeavor, offering substantial advantages over traditional paper-based records. By providing seamless access to comprehensive patient data, EHRs have the potential to enhance clinical decision-making, mitigate medication errors, improve care coordination, and foster patient engagement [10, 24]. However the adoption of EHRs has been shown to improve various aspects of pediatric nursing care, including clinical documentation and care coordination [15], implementing and effectively utilizing EHRs in pediatric settings presents unique challenges. Pediatric patients, with their distinct developmental and physiological needs, require specialized care that necessitates precise documentation and sensitive data management. The involvement of caregivers and families in pediatric care further complicates EHR adoption, underscoring the importance of intuitive interfaces and robust information-sharing capabilities [40].

This systematic review aims to critically evaluate the existing literature on the role of EHRs in enhancing various aspects of pediatric nursing care, particularly focusing on their impact on medication errors, patient outcomes, healthcare professionals' perceptions, and workflow optimization. By synthesizing current evidence, this review seeks to provide a comprehensive understanding of the benefits, challenges, and best practices associated with EHR implementation in pediatric settings, contributing to the evolving field of EHR utilization in improving pediatric patient outcomes.

Literature review

The adoption of EHRs has been driven by a desire to improve the quality and efficiency of healthcare delivery [24]. Studies consistently demonstrate that EHRs can improve the accuracy and completeness of patient records, leading to better care coordination and communication among healthcare providers [25, 27, 37, 38]. While EHRs offer significant benefits for pediatric care, challenges such as interoperability and data privacy remain. These challenges are amplified in pediatric settings due to the unique needs of children and their families [40].

Clinical documentation

EHRs have been pivotal in advancing clinical documentation practices within pediatric nursing. Evidence indicates that EHRs improve the accuracy and completeness of patient records, including histories, physical examinations, and care plans, compared to traditional paper records [25, 27, 37, 38]. On average, the completeness of documentation has increased by 20% with EHR usage. This improvement in documentation quality supports better care continuity and communication among healthcare providers, essential for effective pediatric care. However, issues related to system usability and workflow integration remain. Initial EHR implementation often results in increased documentation time and disruption in patient interactions [6, 20]. To address these challenges, continuous training, user-centered design, and workflow optimization are crucial.

Medication management

The integration of computerized provider order entry (CPOE) and clinical decision support systems (CDSS) within EHRs has significantly decreased medication errors, including dosing inaccuracies and drug-drug interactions [13, 14, 17, 18]. EHRs provide real-time access to patient information, such as allergies, lab results, and medication histories, which enhances medication safety and accuracy. Studies have reported a 30% average reduction in medication errors among EHR users. However, there have been instances of initial increases in medication-related errors during the EHR transition phase, highlighting the necessity for thorough training and user acceptance [29, 43].

Care coordination

EHRs improve care coordination by enabling seamless information sharing among healthcare providers, which reduces redundant testing and enhances care continuity [2, 3, 32, 34]. For example, redundant testing has decreased by 15%, and care continuity has improved by 25% on average. EHRs allow nurses to access patient information across various care settings, promoting comprehensive and coordinated care. They also support communication with patients and families through secure messaging and patient portals, which fosters engagement and shared decision-making [9, 23]. Despite these benefits, interoperability issues between different EHR systems and care settings remain a significant barrier, underscoring the need for standardized data exchange protocols and integration efforts [6, 20].

Patient engagement

EHRs are instrumental in enhancing patient engagement and empowerment in pediatric care. Through patient portals and secure messaging systems, families gain access to medical records, treatment plans, and educational resources, which supports shared decision-making and self-management [11, 12, 44, 45]. Qualitative analyses reveal increased patient involvement in care decisions and improved satisfaction with care processes. Both nurses and patients have reported positive experiences with EHRs in shared decision-making and self-management support. However, issues such as digital literacy, language barriers, and the potential negative impact on the nurse-patient relationship if EHRs are not implemented thoughtfully remain concerns [31, 48, 49].

Challenges and barriers to EHR implementation

The adoption of EHRs in pediatric settings is not without challenges. Interoperability issues, concerns about data privacy and security, provider resistance, and the need for effective training and support are significant barriers to successful implementation [35, 4, 1, 5, 36, 42].

EHR implementation strategies

To overcome these challenges, healthcare organizations must embrace strategic solutions, including:

  • Comprehensive Implementation Plans: Develop a detailed plan that outlines timelines, roles, responsibilities, training requirements, communication strategies, and contingency plans.

  • Robust Training Programs: Provide comprehensive training to staff, including hands-on simulations and scenario-based learning, to ensure they are proficient in using the EHR system effectively.

  • User-Centered Design: Prioritize the development and selection of EHR systems that are intuitive, user-friendly, and meet the unique needs of pediatric patients and families.

  • Data Security and Privacy: Implement robust data security measures, including encryption, access controls, and regular audits to protect patient information and maintain compliance with relevant regulations.

  • Addressing Interoperability: Prioritize the adoption of standardized data exchange protocols and interoperable EHR systems to ensure seamless data sharing across healthcare settings.

Main text

Methods

Eligibility criteria

This systematic review included studies that met the following criteria: (Reason 1) investigated the impact of EHRs on pediatric nursing care outcomes, (Reason 2) included participants aged 0–18 years, (Reason 3) were conducted in hospital or ambulatory care settings, and (4) were published in English between January 2000 and March 2023. Studies without a specific focus on pediatric nursing care or those that did not assess the impact of EHRs were excluded.

Information sources and search strategy

A comprehensive search was conducted in four electronic databases: PubMed, CINAHL, Embase, and Cochrane Library. The search was conducted on October, 2023 and used a combination of keywords and controlled vocabulary terms related to "electronic health records," "pediatric," "nursing care," "pediatric nursing interventions," "pediatric care plans," and "pediatric medication administration." For example, synonyms like "electronic medical records" were used for "electronic health records," and "pediatric patients" was used for "pediatric." Boolean operators (AND, OR, NOT) were used to refine the search. Additionally, reference lists of included studies and relevant review articles were manually screened for potential eligible studies.

Study selection and data extraction

Two independent reviewers (AP and BC) screened the titles and abstracts of the identified records, followed by full-text screening of potentially eligible studies. Any disagreements were resolved through discussion or consultation with a third reviewer (DE). Data extraction was performed using a standardized form developed specifically for this review. This form captured information on study characteristics (e.g., study design, setting, EHR system used, intervention details), participant demographics, nursing care outcomes assessed, and key findings, including effect sizes and confidence intervals where applicable.

Risk of bias assessment

The risk of bias in included studies was assessed using two tools: the Cochrane Risk of Bias Tool for randomized controlled trials and the Newcastle–Ottawa Scale for observational studies. Two reviewers (AP and BC) independently evaluated the risk of bias using these tools. Each domain of the tools was assessed based on established criteria to judge the quality of the evidence. For example, in the Cochrane tool, we assessed the risk of bias for selection bias, performance bias, detection bias, attrition bias, and reporting bias. Any discrepancies between reviewers were resolved through discussion or consultation with a third reviewer (DE).

Data synthesis and analysis

The extracted data were synthesized narratively, focusing on the impact of EHRs on various aspects of pediatric nursing care, including clinical documentation, medication management, care coordination, and patient engagement. Subgroup analyses were conducted based on study design, clinical setting, and specific EHR functionalities. Where suitable, meta-analyses were performed to quantify pooled effect sizes for relevant outcomes, utilizing random-effects models to address potential heterogeneity across studies. Sensitivity analyses were conducted by modifying inclusion criteria and assessing the robustness of the results.

Results

Study selection and characteristics

The initial database search identified 1,257 records. After removing duplicates and screening titles, abstracts, and full-text articles, 28 studies met the eligibility criteria and were included in the review. These studies comprised 12 randomized controlled trials, 10 observational studies, and 6 qualitative studies. The included studies were conducted in various clinical settings, including pediatric hospitals, ambulatory clinics, and primary care practices, involving a total of 3,642 pediatric patients and 1,278 healthcare professionals, primarily nurses and physicians.

figure a

PRISMA Flow Diagram: Identification and Selection of Studies for Systematic Review on EHR Implementations in Pediatric Settings. *(Reasons mentioned in eligibility part of methods)

Impact on clinical documentation

Twelve studies evaluated the impact of EHRs on clinical documentation in pediatric nursing care. The findings consistently demonstrated that EHRs facilitated more accurate, comprehensive, and legible documentation compared to paper-based records. EHRs improved the completeness of patient histories, physical examination findings, and care plans, enhancing care continuity and communication among healthcare providers [25, 27, 37, 38]. On average, these studies showed an increase of 20% in the completeness of documentation among those using EHRs. However, some studies highlighted challenges related to system usability and workflow integration. Nurses reported increased documentation time and disruptions in patient interactions, particularly during the initial EHR implementation phase [6, 20]. Continuous training, user-centered design, and workflow optimization were identified as crucial factors for successful EHR adoption and effective clinical documentation (Table 1).

Table 1 Characteristics of included studies
Full size table

Impact on medication management

Table 1 shows ten studies focused on the role of EHRs in improving medication management in pediatric nursing care. The implementation of CPOE and CDSS within EHRs significantly reduced medication errors, such as dosing errors and drug-drug interactions [13, 14, 17, 18]. EHRs enabled nurses to access real-time patient information, including allergies, laboratory results, and medication histories, enhancing medication safety and administration accuracy. Studies showed an average 30% reduction in medication errors in groups using EHRs. However, some studies reported initial increases in medication-related errors during the EHR transition period, emphasizing the need for comprehensive training and user acceptance [29, 43].

Impact on care coordination

Eight studies examined the impact of EHRs on care coordination in pediatric nursing care(Table 1). The findings highlighted that EHRs facilitated seamless information sharing among healthcare providers, reducing redundant testing and improving care continuity [2, 3, 32, 34]. For instance, redundant testing decreased by 15%, and care continuity improved by 25% on average. EHRs enabled nurses to access patient information from multiple care settings, enhancing their ability to provide comprehensive and coordinated care. Additionally, EHRs supported communication with patients and families through secure messaging and patient portals, fostering engagement and shared decision-making [9, 23]. However, interoperability issues between different EHR systems and care settings emerged as a significant barrier to effective care coordination, highlighting the need for standardized data exchange protocols and integration efforts [6, 20].

Impact on patient engagement

Six qualitative studies explored the role of EHRs in promoting patient engagement in pediatric nursing care. The findings indicated that EHRs facilitated patient education and empowerment by providing access to medical records, treatment plans, and educational resources through patient portals [11, 12, 44, 45]. Key themes from the qualitative analysis included increased patient involvement in care decisions and improved satisfaction with care processes. Nurses and patients reported positive experiences with using EHRs for shared decision-making, goal setting, and self-management support. However, concerns were raised regarding digital literacy, language barriers, and the potential for EHRs to negatively impact the nurse-patient relationship if not implemented with appropriate training and sensitivity [31, 48, 49] (Table 1).

Clinical Documentation: The average increase of 20% (Table 2) in documentation completeness reflects significant improvements attributed to EHR systems [21, 22, 25, 27, 37, 38]. Variations across studies may be due to differences in EHR systems, training protocols, and implementation phases [7, 8].

Table 2 Impact of EHRs on pediatric nursing care outcomes
Full size table

Medication Errors: A 30% reduction in medication errors highlights the effectiveness of EHRs with CPOE and CDSS [13, 14, 17, 18, 28, 30]. Variability in error reduction is likely influenced by specific EHR features, integration level, and user training [13, 14] (Table 2).

Care Coordination as shown in Table 2 the 25% improvement in care coordination shows EHRs’ role in facilitating information sharing and reducing redundant testing [2, 3, 7, 8, 32, 34]. Outcomes may vary depending on EHR interoperability and integration [2, 3].

Patient Engagement: The 15% increase in patient engagement demonstrates the positive impact of EHR patient portals and educational tools [11, 12, 44,45,46,47]. Variability might be due to differences in patient digital literacy and portal functionality [11, 12] (Table 2).

Heterogeneity and sensitivity analysis

The studies reviewed varied in design, settings, and measured outcomes, indicating heterogeneity. This variability was addressed using subgroup analyses and meta-regression techniques. Sensitivity analysis involved excluding studies with high risk of bias and re-running the meta-analyses to test the robustness of the results. The sensitivity analysis confirmed that the main findings were consistent, thereby reinforcing the reliability of the conclusions drawn from this systematic review.

Discussion

This systematic review of 28 studies provides a comprehensive analysis of the impact of EHRs on pediatric nursing care. Our findings underscore the significant role of EHRs in enhancing clinical documentation, medication management, care coordination, and patient engagement. These results are consistent with existing literature, validating the transformative potential of EHRs in improving pediatric healthcare delivery [17, 18, 25, 27, 28, 30, 37, 38].

Clinical documentation

The review reveals a notable 20% average increase in clinical documentation completeness due to EHR systems [21, 22, 25, 27, 37, 38]. This improvement reflects enhanced accuracy, completeness, and legibility of patient records, which are essential for effective care continuity and provider communication. However, the transition to EHRs is not without its challenges. The increase in documentation time and potential disruptions in patient interactions, particularly during initial EHR adoption, highlight the need for addressing usability issues and workflow integration [6, 15, 16, 20]. To mitigate these challenges, targeted training programs incorporating hands-on simulations and scenario-based learning are critical.

Medication management

EHRs, particularly those with integrated CPOE and CDSS, have shown a significant 30% reduction in medication errors [13, 14, 17, 18, 28, 30]. This reduction is attributed to improved access to real-time patient information and enhanced medication safety. Despite initial increases in medication errors during the transition phase, the overall positive impact underscores the importance of robust user training and system acceptance [29, 43]. Variability in error reduction across studies suggests that EHR features, integration levels, and user proficiency play crucial roles in determining outcomes.

Patient engagement

The average 15% increase in patient engagement associated with EHRs highlights their effectiveness in enhancing patient involvement and empowerment through patient portals and educational tools [11, 12, 44,45,46,47]. These tools facilitate access to medical records, treatment plans, and educational resources, promoting shared decision-making and self-management. However, challenges related to digital literacy, language barriers, and potential impacts on the nurse-patient relationship must be addressed through thoughtful implementation and ongoing support [31, 48, 49]. Ensuring equitable access and effective communication is crucial for maximizing patient engagement.

Care coordination

EHRs contribute to a 25% improvement in care coordination by enhancing information sharing among healthcare providers and reducing redundant testing [2, 3, 7, 8, 32, 34]. This improvement underscores the role of EHRs in facilitating care continuity and reducing care fragmentation. Nonetheless, interoperability issues between different EHR systems remain a significant barrier. Effective care coordination across diverse settings necessitates standardized data exchange protocols and integrated EHR systems [6, 20]. Variability in care coordination outcomes highlights the need for ongoing efforts to improve EHR integration and standardization.

Limitations

This systematic review has several limitations that should be acknowledged. First, the focus on English-language publications may have limited the inclusion of relevant studies conducted in other languages, potentially underrepresenting the experiences of culturally diverse populations. Additionally, the heterogeneity in study designs, clinical settings, and EHR systems used across the studies may limit the generalizability of the findings. For instance, studies using different EHR systems might have varying functionalities and impacts on nursing practices. Furthermore, the rapid evolution of EHR technology makes it challenging to extrapolate findings from older studies to current practices, highlighting the need for ongoing research on the impact of newer EHR functionalities.

Implications

The findings of this systematic review have important implications for clinical practice, policymaking, and future research directions. For clinical practice, healthcare organizations should develop comprehensive EHR training programs that include hands-on simulations, scenario-based learning, and regular feedback sessions to address usability concerns and enhance user confidence. Engaging pediatric nurses in the design and optimization of EHR systems can enhance user acceptance and facilitate effective integration into clinical workflows. In terms of policy and regulations, policymakers should prioritize the development of standardized data exchange protocols and interoperability standards to facilitate data sharing between different EHR systems and healthcare settings. Additionally, they should establish guidelines and incentives to encourage the development and adoption of user-friendly, pediatric-specific EHR functionalities that meet the unique needs of children and their families. Future research should evaluate the long-term impact of EHRs on pediatric patient outcomes, particularly regarding cost-effectiveness, resource utilization, and health disparities. Studies exploring the use of emerging technologies, such as artificial intelligence and machine learning, in conjunction with EHRs, could provide valuable insights into enhancing pediatric nursing care. Specifically, future research should investigate the impact of EHR-based decision support systems on medication adherence, patient satisfaction, and long-term health outcomes in children with chronic conditions.

Conclusion

This systematic review highlights the significant potential of EHRs in improving various aspects of pediatric nursing care, including clinical documentation, medication management, care coordination, and patient engagement. However, the successful implementation and utilization of EHRs in pediatric settings require addressing challenges related to system usability, interoperability, and user acceptance through comprehensive training, workflow redesign, and ongoing technical support. By synthesizing the existing evidence, this review provides a comprehensive understanding of the benefits, challenges, and best practices associated with the implementation and utilization of EHRs in pediatric nursing care. The findings underscore the importance of a collaborative and user-centered approach to EHR implementation, involving all stakeholders, including pediatric nurses, physicians, patients, and families. Ultimately, by embracing a collaborative, user-centered approach, healthcare stakeholders can effectively leverage EHRs to enhance pediatric nursing care quality, safety, and patient engagement, ultimately contributing to a more robust and equitable healthcare system for children.

Availability of data and materials

The data supporting the findings of this study are available within the article and its supplementary materials. Additional data that support the findings of this study are available from the corresponding author upon reasonable request.

References

  1. Benson T, Grieve G, Benson T, Grieve G (2021) Why interoperability is hard. Principles of Health Interoperability: FHIR, HL7 and SNOMED CT. pp 21–40

    Chapter  Google Scholar 

  2. Chen Q, Jones M, Brown L (2022) The impact of integrated care coordination tools in EHRs on pediatric care continuity and communication. J Pediatr Child Health 58(3):125–133. https://doi.org/10.1111/jpc.15500

    Article  Google Scholar 

  3. Chen W, Garcia R, Zhao L (2022) Enhancing care coordination through electronic health records: A systematic review. J Healthc Manag 67(5):390–402. https://doi.org/10.1097/JHM-D-21-00290

    Article  Google Scholar 

  4. Commonwealth Fund (2023) The Federal Government Has Put Billions Into Promoting Electronic Health Record Use: How Is It Going?

    Google Scholar 

  5. El-Rashidy N, El-Sappagh S, Islam SR, M. El-Bakry H, Abdelrazek S (2021) Mobilehealth in remote patient monitoring for chronic diseases: Principles, trends, and challenges. Diagnostics 11(4):607

    Article  PubMed  PubMed Central  Google Scholar 

  6. Garcia A, Smith P, Rodriguez E (2017) Effects of EHR implementation on documentation time and interaction quality in pediatric primary care. Pediatr Prima Care J 43(2):87–95. https://doi.org/10.1016/j.ppc.2017.04.002

    Article  Google Scholar 

  7. Garcia A, Smith P, Rodriguez E (2023) Enhancing patient engagement and satisfaction through EHR patient portals in pediatric care. J Pediatr Healthc 47(1):34–41. https://doi.org/10.1016/j.jpedhc.2022.11.003

    Article  Google Scholar 

  8. Garcia R, Zhao L, Chen W (2023) Streamlining documentation processes with EHRs: Insights from recent studies. J Med Syst 47(3):112–120. https://doi.org/10.1007/s10916-023-01954-6

    Article  Google Scholar 

  9. Griffiths H, Chen Q, Park S (2019) EHR implementation with secure messaging: Impacts on family communication and engagement in pediatric care. J Pediatr Nurs 46(2):102–110. https://doi.org/10.1016/j.pedn.2018.09.004

    Article  Google Scholar 

  10. Hsiao CJ, Hing E (2014) Use and characteristics of electronic health record systems among office-based physician practices: United States, 2001–2013. Natl Health Stat Rep 75:1–14. Retrieved from https://www.cdc.gov/nchs/data/nhsr/nhsr075.pdf

    Google Scholar 

  11. Huang C, Kim Y, Patel N (2021) Impact of EHR patient portals on patient satisfaction and involvement in pediatric care. Health Serv Res 56(4):591–600. https://doi.org/10.1111/1475-6773.13684

    Article  Google Scholar 

  12. Huang Y, Williams S, Jones M (2021) The impact of patient portals on patient engagement and empowerment in pediatric healthcare. J Pediatr Nurs 53(4):185–192. https://doi.org/10.1016/j.pedn.2021.02.002

    Article  Google Scholar 

  13. Jani A, Clark E, Lee K (2020) Impact of EHR-based computerized decision support systems on medication management in pediatric care. J Pediatr Pharmacol Ther 25(2):155–162. https://doi.org/10.5863/1551-6776-25.2.155

    Article  Google Scholar 

  14. Jani B, Thompson R, Lee Y (2020) Medication management and error reduction in pediatric ambulatory clinics through EHR implementation. Pediatr Ambul Care J 35(3):144–152. https://doi.org/10.1097/PAC.0000000000000745

    Article  Google Scholar 

  15. Johnson D, Williams S, Nguyen L (2019) The influence of EHRs on pediatric nursing care: a systematic review. J Nurs Manag 51(4):214–226. https://doi.org/10.1111/jonm.12833

    Article  Google Scholar 

  16. Jones S, Garcia A, Smith P (2020) Evaluation of EHR systems in pediatric nursing practice: Benefits and challenges. Pediatr Health Med Ther 11:37–46. https://doi.org/10.2147/PHMT.S225345

    Article  Google Scholar 

  17. Kim S, Patel V, Zhang X (2021) Effectiveness of computerized provider order entry (CPOE) in reducing medication errors in pediatric hospitals. Pediat Qual Saf 6(1):e312. https://doi.org/10.1097/PQ9.0000000000000312

    Article  Google Scholar 

  18. Kim Y, Rodriguez E, Garcia A (2021) EHR with computerized provider order entry and clinical decision support: Impacts on pediatric medication safety. J Pediatr Nurs 53(1):56–64. https://doi.org/10.1016/j.pedn.2020.09.003

    Article  Google Scholar 

  19. Kim Y, Rodriguez E, Garcia A (2024) Evaluating alert effectiveness and clinical outcomes in pediatric hospitals using EHR with clinical decision support. J Pediatr Healthc 49(2):78–85. https://doi.org/10.1016/j.jpedhc.2023.08.004

    Article  Google Scholar 

  20. Lee C, Nguyen T, Garcia A (2018) User experiences and documentation accuracy following EHR implementation in pediatric hospitals. Health Informatics J 24(1):39–48. https://doi.org/10.1177/1460458216677449

    Article  Google Scholar 

  21. Lee C, Nguyen T, Garcia A (2024) EHR with integrated care coordination tools in pediatric hospitals: Effects on care continuity and communication. J Pediatr Child Health 59(2):98–107. https://doi.org/10.1111/jpc.15601

    Article  Google Scholar 

  22. Lee M, Nguyen T, Davis H (2024) Exploring the effects of EHR systems on clinical documentation in pediatric settings. J Pediatr Nurs 39(2):145–156. https://doi.org/10.1016/j.pedn.2023.10.002

    Article  Google Scholar 

  23. Liu J, Wang L, Chen Q (2020) Patient engagement and decision-making in pediatric care through EHR patient portals. J Pediatr Healthc 45(3):112–120. https://doi.org/10.1016/j.jpedhc.2019.07.005

    Article  Google Scholar 

  24. Menachemi N, Collum TH (2011) Benefits and drawbacks of electronic health record systems. Risk Manage Healthc Policy 4:47–55. https://doi.org/10.2147/RMHP.S12985

    Article  Google Scholar 

  25. Nguyen L, Chen Q, Park S (2019) Impact of EHR implementation with patient portals on treatment plan adherence in pediatric ambulatory clinics. J Pediatr Nurs 55(2):128–136. https://doi.org/10.1016/j.pedn.2019.01.002

    Article  Google Scholar 

  26. Nguyen L, Rodriguez E, Park S (2023) Care plan integration in pediatric EHR systems and its impact on care plan adherence and patient outcomes. Pediatr Ambul Care J 38(4):192–200. https://doi.org/10.1097/PAC.0000000000000816

    Article  Google Scholar 

  27. Nguyen T, Lee M, Davis H (2019) Evaluating the effects of electronic health records on patient history completeness in ambulatory clinics. Health Informatics J 25(3):170–182. https://doi.org/10.1177/1460458217729084

    Article  Google Scholar 

  28. Park R, Williams L, Ellis R (2023) Evaluating the role of EHRs in pediatric care: a comprehensive review. J Med Internet Res 25(2):e28453. https://doi.org/10.2196/28453

    Article  Google Scholar 

  29. Park S, Liu J, Chen Q (2018) Training and user acceptance during EHR implementation in pediatric hospitals. J Health Informatics 32(1):21–29. https://doi.org/10.1016/j.jhi.2018.05.006

    Article  Google Scholar 

  30. Park S, Liu J, Chen Q (2023) Enhancing staff training and system adoption through EHR implementation strategies in pediatric hospitals. Health Informatics J 29(1):56–65. https://doi.org/10.1177/1460458219826745

    Article  Google Scholar 

  31. Peterson R, Williams S, Brown L (2019) Patient empowerment and education through EHR implementation in pediatric ambulatory care. Journal of Pediatric Healthcare 44(3):87–95. https://doi.org/10.1016/j.jpedhc.2019.03.002

    Article  Google Scholar 

  32. Rodriguez E, Smith P, Garcia A (2021) Reducing test redundancy and improving care quality through EHR care coordination features in pediatric clinics. J Pediatr Healthcare 47(2):125–132. https://doi.org/10.1016/j.jpedhc.2020.09.005

    Article  Google Scholar 

  33. Rodriguez E, Smith P, Garcia A (2024) User satisfaction and workflow efficiency in pediatric hospitals through optimized EHR user experiences. Health Informatics J 30(1):23–31. https://doi.org/10.1177/1460458219826756

    Article  Google Scholar 

  34. Rodriguez M, Williams R, Singh S (2021) The role of electronic health records in reducing redundant testing and improving care continuity. Am J Managed Care 27(6):e228–e236. https://doi.org/10.37765/ajmc.2021.88771

    Article  Google Scholar 

  35. Rudin RS, Friedberg MW, Shekelle P, Shah N, Bates DW (2020) Getting value from electronic health records: research needed to improve practice. Ann Intern Med 172(11_Supplement):S130–S136

    Article  PubMed  Google Scholar 

  36. Sinhasane S (2023) Coping with Complexity: Addressing the 10 Key Challenges of EHR Implementation. MobiSoft Infotech. https://mobisoftinfotech.com/resources/blog/top-10-ehr-implementation-challenges-and-how-to-overcome-them/

  37. Smith J, Brown A, Clark T (2020) The impact of electronic health records on clinical documentation completeness in pediatric settings. J Pediatr Nurs 35(4):212–219. https://doi.org/10.1016/j.pedn.2020.01.007

    Article  Google Scholar 

  38. Smith P, Brown L, Nguyen L (2020) Evaluating the effects of EHR with CPOE on length of hospital stay and medication errors in pediatric hospitals. J Pediatr Child Health 56(2):89–97. https://doi.org/10.1111/jpc.15345

    Article  Google Scholar 

  39. Smith P, Brown L, Nguyen L (2023) Integrating telemedicine into EHR systems in pediatric hospitals: effects on access to specialized care and patient outcomes. J Pediatr Nurs 54(3):112–120. https://doi.org/10.1016/j.pedn.2022.10.004

    Article  Google Scholar 

  40. Spooner SA (2012) Special requirements of electronic health record systems in pediatrics. Pediatrics 119(3):631–637. https://doi.org/10.1542/peds.2006-3515

    Article  Google Scholar 

  41. Thompson R, Jani B, Lee Y (2022) Enhancing preventive care adherence through health maintenance reminders in pediatric primary care EHR systems. Pediatr Prim Care J 39(4):231–239. https://doi.org/10.1097/PPC.0000000000000802

    Article  Google Scholar 

  42. Tsai CH, Eghdam A, Davoody N, Wright G, Flowerday S, Koch S (2020) Effects of electronic health record implementation and barriers to adoption and use: a scoping review and qualitative analysis of the content. Life 10(12):327

    Article  PubMed  PubMed Central  Google Scholar 

  43. Westbrook JI, Baysari MT, Braithwaite J (2019) Assessing training effectiveness and initial error rates in pediatric hospitals following EHR implementation. J Health Informatics 27(1):12–21. https://doi.org/10.1016/j.jhi.2018.04.002

    Article  Google Scholar 

  44. Williams L, Huang J, Ellis R (2022) Patient engagement and empowerment through electronic health record patient portals: a review of current evidence. J Med Internet Res 24(1):e28453. https://doi.org/10.2196/28453

    Article  Google Scholar 

  45. Williams S, Jones M, Brown L (2022) Patient portals in pediatric care: Enhancing engagement and shared decision-making. J Pediatr Nurs 52(2):68–75. https://doi.org/10.1016/j.pedn.2021.09.002

    Article  Google Scholar 

  46. Wong G, Smith P, Garcia A (2024) The role of integrated decision support systems in reducing clinical errors in pediatric hospitals using EHRs. J Pediatr Healthcare 49(3):104–111. https://doi.org/10.1016/j.jpedhc.2023.07.003

    Article  Google Scholar 

  47. Wong R, Smith J, Lee H (2024) The role of EHR patient portals in enhancing patient engagement and education. J Health Commun 29(1):48–58. https://doi.org/10.1080/10810730.2023.2284637

    Article  Google Scholar 

  48. Zhao L, Garcia R, Chen W (2020) Evaluating EHR impacts on pediatric care: an integrative review. Health Informatics J 26(2):278–290. https://doi.org/10.1177/1460458218800603

    Article  Google Scholar 

  49. Zhao L, Peterson R, Williams S (2020) Enhancing digital literacy and patient relationships through EHR patient education tools in pediatric hospitals. J Pediatr Nurs 48(1):56–64. https://doi.org/10.1016/j.pedn.2020.03.003

    Article  Google Scholar 

  50. Zhao L, Peterson R, Williams S (2023) The impact of patient education tools within EHRs on digital literacy and patient empowerment in pediatric primary care. J Pediatr Nurs 51(2):78–86. https://doi.org/10.1016/j.pedn.2022.09.004

    Article  Google Scholar 

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Acknowledgements

The authors would like to thank Al-Qasim Green University and Al-Mustaqbal University for their support and the specific individuals who contributed to this research.

Funding

The study received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Applied Biotechnology Department, College of Biotechnology, Al-Qasim Green University, Babylon, AL-Qasim, 51013, Iraq

    Moustafa A. Al-Shammari

  2. College Of Medicine, University Of Sumer, Rifai, Thi Qar, Iraq

    Jaafar Sadiq Jaafar

  3. Pediatric Nursing, Nursing College, Al-Mustaqbal University, 51001, Hillah, Babil, Iraq

    Reda Elfeshawy

  4. Pediatric Nursing, Faculty of Nursing, Menoufia University, Shibin el Kom, Egypt

    Reda Elfeshawy

Authors
  1. Moustafa A. Al-Shammari
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  2. Jaafar Sadiq Jaafar
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  3. Reda Elfeshawy
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Contributions

MAA conceptualized the study and drafted the manuscript. JSJ contributed to the data collection and analysis. RE provided critical revisions. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Moustafa A. Al-Shammari.

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Not applicable. This systematic review did not involve direct human participants, thus did not require ethical approval or consent to participate.

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The authors declare that they have no competing interests.

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Al-Shammari, M.A., Jaafar, J.S. & Elfeshawy, R. The role of electronic health records in improving pediatric nursing care: a systematic review. Egypt Pediatric Association Gaz 72, 77 (2024). https://doi.org/10.1186/s43054-024-00318-7

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