Estimating the association between burnout and electronic health record-related stress among advanced practice registered nurses

Appl Nurs Res. 2018 Oct;43:36-41. doi: 10.1016/j.apnr.2018.06.014. Epub 2018 Jun 23.


Background: Health information technology (HIT), such as electronic health records (EHRs), is a growing part of the clinical landscape. Recent studies among physicians suggest that HIT is associated with a higher prevalence of burnout. Few studies have investigated the workflow and practice-level predictors of burnout among advanced practice registered nurses (APRNs).

Aim: Characterize HIT use and measure associations between EHR-related stress and burnout among APRNs.

Methods: An electronic survey was administered to all APRNs licensed in Rhode Island, United States (N = 1197) in May-June 2017. The dependent variable was burnout, measured with the validated Mini z burnout survey. The main independent variables were three EHR-related stress measures: time spent on the EHR at home, daily frustration with the EHR, and time for documentation. Logistic regression was used to measure the association between EHR-related stress and burnout before and after adjusting for demographics, practice-level characteristics, and the other EHR-related stress measures.

Results: Of the 371 participants, 73 (19.8%) reported at least one symptom of burnout. Among participants with an EHR (N = 333), 165 (50.3%) agreed or strongly agreed that the EHR added to their daily frustration and 97 (32.8%) reported an insufficient amount of time for documentation. After adjustment, insufficient time for documentation (AOR = 3.72 (1.78-7.80)) and the EHR adding to daily frustration (AOR = 2.17 (1.02-4.65)) remained predictors of burnout.

Conclusions: Results from the present study revealed several EHR-related environmental factors are associated with burnout among APRNs. Future studies may explore the impact of addressing these EHR-related factors to mitigate burnout among this population.

Keywords: APRN; Burnout; Electronic health record; Health information technology.

MeSH terms

  • Adult
  • Advanced Practice Nursing*
  • Aged
  • Aged, 80 and over
  • Burnout, Professional*
  • Electronic Health Records*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nursing Staff / psychology*
  • Young Adult