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BMJ Open. October 7, 2021; 11 (10): e055847. doi: 10.1136 / bmjopen-2021-055847.


INTRODUCTION: Electronic medical record (EMR) systems are used worldwide as a repository for patient clinical information, providing clinical decision support and increasing visibility and access to clinical information. As EMR systems facilitate improved healthcare delivery, new reports suggest potential adverse effects on the well-being of clinicians. The influences of EMR system implementation on nurse job motivation, engagement, satisfaction and well-being (including burnout) are not well understood and have not been examined in relation to contextual factors and mechanisms of action. This article presents a realistic review protocol for examining causal explanations to answer the question: how, why, and under what circumstances did the implementation of a new hospital EMR system or similar technology have an impact on the motivation, commitment, satisfaction or well-being of nurses at work?

METHODS AND ANALYSIS: The five-step method for a realistic review will be used to identify causal relationships, how relationships work, for whom and under what circumstances: (1) define the scope of the review; (2) develop initial program theories; (3) search for evidence; (4) select and assess evidence; (5) extract and synthesize data. The initial theories for the program were developed using the results of the scoping review and qualitative data collected from nurses before and after the EMR. Five databases will be systematically searched from January 1, 2000 to October 31, 2021 (APA PsycInfo, CINAHL, Embase, IEEE Xplore and MEDLINE Complete), and forward and backward citation searches, gray literature searches and literature searches. recommended by the research team. The research results will be reviewed by two members of the research team. The extracted data will help refine the theories of the program to develop a conceptual model that synthesizes how job motivation, engagement, satisfaction and well-being can influence or be influenced by the implementation of an EMR.

ETHICS AND DISSEMINATION: The largest project has already obtained low risk ethics approval. The review will be published in a peer-reviewed journal and reported in accordance with RAMESES guidelines.


PMID: 34620677 | DOI: 10.1136 / bmjopen-2021-055847

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