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Currently submitted to: JMIR Nursing

Date Submitted: Nov 1, 2019
Open Peer Review Period: Nov 1, 2019 - Dec 27, 2019
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Understanding Complex Factors That Influence the Adoption and Use of Electronic Nursing Documentation: A Scoping Review

  • Amy Williams; 
  • Elizabeth Borycki; 
  • Andre Kushniruk; 



While the basic intent of all nursing documentation is to be representative of what the nurse does with and for the patient, each nursing professional association has identified and legislated documentation standards. Despite these standards, several challenges exist leading to documentation burden and ultimately the introduction of electronic nursing documentation to support evidence-based care.


The objective of this scoping review was to evaluate the complex factors including enablers, mediating/moderating factors and barriers that influence adoption and use, and its outputs related to electronic clinical documentation by nurses. The analysis of the data will advance an understanding of the factors influence adoption of electronic nursing documentation and the resulting output.


A scoping review of literature was conducted on electronic nursing documentation. The reviewers utilized the Arksey and O’Malley methodological framework for all five stages of the scoping review.


Following the data-charting phase, 13 key themes were identified in articles that discussed factors that influence the adoption of electronic nursing documentation. The dominant and recurring themes were grouped according to the category they aligned with (i.e. structure, process, or outcomes) within the Donabedian Framework.


Factors that influence the adoption of electronic nursing documentation are multifactorial, interrelated and require careful consideration for implementation and support. A thorough evaluation of structures, processes, and individual user characteristics are required to understand the root causes of adoption levels and potential mitigating factors. Further research is required to understand the impacts that adoption has on clinical outcomes.


Please cite as:

Williams A, Borycki E, Kushniruk A

Understanding Complex Factors That Influence the Adoption and Use of Electronic Nursing Documentation: A Scoping Review

JMIR Preprints. 01/11/2019:16881

DOI: 10.2196/preprints.16881


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