WIRED BUT WORN OUT: A SYSTEMATIC REVIEW OF ELECTRONIC HEALTH RECORD USABILITY AND ITS ASSOCIATION WITH NURSE BURNOUT
Main Article Content
Keywords
Electronic Health Records; EHR usability; nurse burnout; nursing informatics; documentation burden; workflow efficiency; occupational stress.
Abstract
Background: Electronic Health Records (EHRs) have become an essential component of contemporary healthcare systems, supporting clinical documentation, communication, and care coordination. Despite their intended benefits, concerns have emerged regarding the usability of EHR systems and their impact on nurses' work experiences. Poorly designed interfaces, excessive documentation requirements, and workflow inefficiencies may contribute to increased occupational stress and burnout among nurses. Objective: This systematic review aimed to synthesize the existing evidence on the relationship between EHR usability and nurse burnout, with particular attention to usability-related factors that may influence nurses’ psychological well-being, job satisfaction, and professional performance. Methods: A systematic search of PubMed, Scopus, Web of Science, CINAHL, and Embase was conducted to identify studies examining EHR usability and burnout among nurses. Eligible studies included quantitative, qualitative, and mixed-methods research published in English that evaluated nurses’ experiences with EHR systems and reported burnout-related outcomes. Study selection, data extraction, and quality appraisal were performed according to established systematic review guidelines. Due to methodological heterogeneity across studies, findings were synthesized narratively. Results: The reviewed literature consistently demonstrated an association between poor EHR usability and higher levels of nurse burnout. Common usability concerns included cumbersome documentation processes, inefficient navigation, alert fatigue, system complexity, inadequate interoperability, and disruptions to clinical workflow. These challenges were frequently linked to emotional exhaustion, increased cognitive workload, reduced job satisfaction, and greater intention to leave the profession. Conversely, studies reported that user-centered system design, streamlined documentation processes, effective training, and organizational support were associated with more positive user experiences and lower burnout levels. Conclusion: EHR usability appears to be an important organizational and technological factor influencing nurse burnout. Improving system usability through user-centered design, workflow optimization, and ongoing evaluation may help reduce documentation burden and support nurse well-being. Future longitudinal and intervention-based studies are needed to clarify causal relationships and identify effective strategies for mitigating technology-related burnout in nursing practice.