PERCEPTION AND ATTITUDE TOWARDS ELECTRONIC HEALTH RECORD FOR CARE OF PATIENT AMONG PERIOPERATIVE NURSES

TOPIC IS SUITABLE FOR:
1-Nursing Science
2-Health Information Management
3-Public Health

TOPIC:  PERCEPTION AND ATTITUDE TOWARDS ELECTRONIC HEALTH RECORD FOR CARE OF PATIENT AMONG PERIOPERATIVE NURSES

TABLE OF CONTENT
Abstract
CHAPTER ONE: INTRODUCTION
1.1 Background of the Study
1.2 Statement of the Problem
1.3 Objective of the Study
1.4 Research Questions
1.5 Significance of the Study
1.6 Scope of the Study
1.7 Definition of Terms
CHAPTER TWO: REVIEW OF LITERATURE
2.1 Conceptual Framework
2.2 Theoretical Framework
2.3 Empirical Review
2.4 Summary of Literature Review
CHAPTER THREE: METHODOLOGY    
3.1 Research Design    
3.2 Research Setting         
3.3 Target population                                  
3.4 Sample size 
3.5 Sampling technique    
3.6 Instruments for data collection     
3.7 Validity and Reliability of Instrument
3.8. Pilot Study    
3.9 Method of data collection 
3.10 Method of data analysis     
CHAPTER FOUR: DATA PRESENTATION AND ANALYSIS
4.0 Introduction
4.1 Data Presentation
4.2 Demographic Analysis 
4.3 Analysis of the Perception of Perioperative Nurses towards the Use of Electronic Health Records (EHRs) for Patient Care in University of Benin Teaching Hospital
4.4 Analysis of the Attitudes of Perioperative Nurses towards the Adoption and Utilization of Electronic Health Records for Patient Care in University of Benin Teaching Hospital
CHAPTER FIVE: DISCUSSION OF FINDINGS
5.1 Discussion of Findings    
5.2 Implications of findings to nursing                            
5.3 Limitations of the study                            
5.4 Summary of the study                                      
5.5 Conclusion                                    
5.6 Recommendations                                 
5.7 Suggestions for further studies  
References
Appendix

ABSTRACT 
This study was carried out to examine the perception and attitude towards Electronic Health Records for care of patients among perioperative nurses in University of Benin Teaching Hospital. The study was specifically carried out to assess the perception of perioperative nurses towards the use of Electronic Health Records (EHRs) for patient care in University of Benin Teaching Hospital, examine the attitudes of perioperative nurses towards the adoption and utilization of Electronic Health Records for patient care in University of Benin Teaching Hospital, determine the perceived benefits of Electronic Health Records in improving patient care among perioperative nurses in University of Benin Teaching Hospital and assess the factors influencing perioperative nurses’ attitudes towards the use of Electronic Health Records in University of Benin Teaching Hospital. The study employed the descriptive survey research design. The population of the study comprised 63 perioperative nurses working in University of Benin Teaching Hospital. A sample size of 54 respondents was determined using Taro Yamane formula, while a validated sample size of 41 respondents participated in the study. Multi-stage sampling technique involving stratified and convenience sampling methods was adopted for the selection of respondents. Hence, the questionnaire was used for data collection, while the data collected were analyzed using frequency tables and percentages. From the responses obtained and analyzed, the findings revealed that perioperative nurses demonstrated a positive perception towards the use of Electronic Health Records as 63.4% agreed that Electronic Health Records improve the accuracy of patient information documentation, while 68.2% agreed that Electronic Health Records contribute to better organization and retrieval of patient records. The study also showed that perioperative nurses exhibited a positive attitude towards the adoption and utilization of Electronic Health Records as 58.6% expressed willingness to use Electronic Health Records regularly for patient care and 61.0% encouraged colleagues to utilize the system. Likewise, the study further revealed that 63.4% agreed that Electronic Health Records improve the quality of patient care through timely access to clinical information, while 61.0% agreed that adequate training positively influences their willingness to use Electronic Health Records. The study therefore recommends that hospital management should organize regular training programmes on Electronic Health Records, provide adequate technical support services, strengthen technological infrastructure and promote supportive policies that encourage effective utilization of Electronic Health Records for improved patient care outcomes.
Keywords: Electronic Health Records, Perioperative Nurses, Patient Care, Perception, Attitude.

CHAPTER ONE
INTRODUCTION (Preview)
1.1 Background of the Study
The infusion of technology innovations to improve the quality, safety, and efficiency of health care services has ushered in major changes for health systems around the globe. As digital technologies have increasingly come into use, the way that healthcare information is managed has changed, and healthcare providers can now more easily capture, access, share, and use patient-related information to support clinical decisions. The importance of effective information management in the delivery of health services has grown to be essential due to the need for accurate and timely information to ensure continuity of care and patient safety, as well as to guide evidence-based practice. Maarsingh et al. (2022) stated that digital technologies were more and more introduced as vital parts of the healthcare systems because of their potential to facilitate communication and enhance the healthcare processes. Technological developments played a significant role in the modernization of healthcare delivery and reinforced patient-centric healthcare approaches, according to Budd (2023). Likewise, Albert et al. (2025) noted that digital transformation was becoming a key strategy adopted by healthcare institutions across the globe to enhance operational efficiency and service quality. Thus, there is an increasing shift towards technology in healthcare environments, which has impacted the behaviours and roles of healthcare workers and specifically for nurses who have a pivotal role in the care of patients.
As digital technologies have taken center stage in the healthcare industry, Electronic Health Records (EHRs) have become a crucial innovation in health information management. The Electronic Health Record (EHR) is an electronic version of patients' health information that is systematically collected, stored, managed and shared among authorized and qualified healthcare providers across various settings. Nguyen et al. (2021) define EHRs as a complete electronic repository of patient data that includes medical history, diagnosis, treatments, and prescriptions, as well as laboratory results, patient demographics, and other clinical information. Ekundayo and Adesina (2021) said that EHR systems empowered the efficient documentation and retrieval of patient information, along with coordinated healthcare delivery. Adeniyi et al. (2024) also stated that EHR enabled healthcare providers to access patient information in real-time, contributing to effective communication and continuity of care. Further, Otu et al. (2025) reported that EHR systems facilitated the management of information and aided in informed clinical decision-making in healthcare institutions. In this increasingly digital age, Electronic Health Records are now a vital part of the healthcare system, used for patient data management and the delivery of healthcare.
Nurses are one of the major users of patient information systems, and their involvement in the use of Electronic Health Records (EHRs) has had a significant impact on nursing practice. In the nursing role, there is a constant need for accurate and timely information for documentation, monitoring, communication and coordination of patient care. Perception is a person's comprehension, belief, interpretation, and opinion of a phenomenon and attitude is the feelings, predispositions, and tendencies to act toward a phenomenon. Similarly, the attitudes of healthcare professionals towards health technology shaped their adoption and use of digital technology in healthcare. (Olukemi et al., 2024) According to Sarraf and Ghasempour (2025), positive perceptions of EHRs correlated with higher levels of acceptance and interaction with digital health tools and systems. Similarly, Shrestha et al. (2025) reported that nurses' attitude towards electronic documentation systems contributed to their engagement with HITs and their experiences in health care settings with technology. It is, therefore, essential to understand perception and attitude towards EHRs as they give a clue about the relationship and engagement of healthcare professionals with digital information systems in patient-care activities.
Perioperative nursing is a specialized field within nursing that concentrates on the care of patients in the pre-, intra-, and post-operative stages. Perioperative nurses have a vital role in assessing patients, preparing them for surgery, providing patient support during the surgical procedure, monitoring patients after surgery, communicating with multiple healthcare disciplines and maintaining accurate patient documentation. Electronic Health Records are important tools for structuring and conveying patient information throughout the surgical experience, considering the information-intensive nature of perioperative care. The clinical coordination and sharing of health information among healthcare professionals caring for a patient were increasingly supported by DHIS as per Otu et al. (2025). Albert et al. (2025) also noted the ongoing enhancement of clinical processes and patient data access in specialized care environments through healthcare technologies. In a setting where timely and accurate information is a key component of effective patient care, the perception and attitude of the perioperative nurse toward the EHR continues to be relevant in the current practice of nursing. Hence, this study is grounded on the perception and attitude of perioperative nurses in relation to Electronic Health Records care of patients and intends to shed a light on the context in which they are dealing with digital health information systems in clinical settings.

1.2 Statement of the Problem
Incorporating digital technologies into healthcare systems has been a constant presence, transforming clinical practice, especially regarding patient data management and care coordination. At the heart of this shift are Electronic Health Records (EHRs), which have revolutionized patient care by facilitating real-time recording, access, and sharing of patient data across health care environments. Digital health systems have played a major role in improving the efficiency and communication in the healthcare sector, as highlighted by Budd (2023), and health information technologies have improved the organization of clinical workflows and the accessibility of data, as stated by Maarsingh et al. (2022). Likewise, Albert et al. (2025) mentioned that healthcare institutions progressively depend on electronic systems to help in decision-making and enhance service delivery outcomes. In the field of perioperative nursing, where timely and accurate information is paramount in providing surgical care, the use of Electronic Health Records is essential in a modern nursing practice. However, the success of such systems is very much dependent upon the attitude and response of healthcare professionals to them.
Although now EHRs are being used in healthcare settings, evidence suggests that there is still inconsistent use and acceptance by healthcare workers, especially nurses working in the peri-operative environment. Effective implementation of EHR systems in clinical settings should allow for smooth integration with existing workflows, providing a seamless and efficient clinical experience for nurses.The ideal practice of EHR systems in the clinical setting should be one that integrates seamlessly with existing workflows, ensuring accurate documentation, patient safety, and continuity of care. Ekundayo and Adesina (2021) noted that while EHR systems were intended to enhance the efficiency in patient information managing, their effectiveness was contingent on the users' acceptance and competence. Adeniyi et al. (2024) further noted that issues with adaptation to digital systems can impact the quality of care provision and the effectiveness of communication among healthcare providers. Otu et al. (2025) also cited that effective use of electronic records can be hindered by challenges in adaptation to digital systems, which can affect their intended benefits in clinical practice. This situation indicates that there is a gap between the anticipated advantages of EHR usage and their actual utilization.
The central issue, however, is the ambiguity of perioperative nurse perceptions and attitudes regarding EHR use in patient care that may impact optimal use of EHR in surgical contexts. Although it is hoped that EHR systems will provide a way to report and record documentation more accurately, better coordination, and to provide evidence for a more effective approach to peri-operative care, there is concern that these systems may not be as effective if nurses are not fully committed to using them or if they do not positively engage with them. The attitudes found to significantly influence the technology adoption by the nurses in the study by Shrestha et al. (2025) and the importance of perception to determine nurses' willingness to use digital health tools effectively were reported by Sarraf and Ghasempour (2025). Success in the implementation of electronic systems also involved technical competence and positive user dispositions, according to Nguyen et al. (2021). This study is intended to fill the gap in the literature regarding the perception and behaviors of perioperative nurses towards EHR, in order to develop evidence for facilitating the use and integration of EHR in surgical care settings.
1.3 Objectives of the Study
The main purpose of this study is to critically assess the perception and attitude towards electronic health record for care of patient among perioperative nurses.  Specifically, the study seeks; 
1.Assess the perception of perioperative nurses towards the use of Electronic Health Records (EHRs) for patient care in University of Benin Teaching Hospital.
2.Examine the attitudes of perioperative nurses towards the adoption and utilization of Electronic Health Records for patient care in University of Benin Teaching Hospital.
3.Determine the perceived benefits of Electronic Health Records in improving patient care among perioperative nurses in University of Benin Teaching Hospital.
4.Assess the factors influencing perioperative nurses’ attitudes towards the use of Electronic Health Records in University of Benin Teaching Hospital.
OTHER PARTS OF CHAPTER ONE INCLUDE:
1.4 Research Question (s)
1.5 Significance of the Study
1.6 Scope of the Study
1.7 Operational Definition of Terms 

CHAPTER TWO
REVIEW OF LITERATURE (Preview) 
This chapter critically examines relevant literature that would assist in explaining the research problem and, furthermore, recognizes the efforts of scholars who had previously contributed immensely to similar research. The chapter intends to deepen the understanding of the study and close the perceived gaps. This chapter, therefore, focuses on the concept of electronic health records, the perception of perioperative nurses towards electronic health records, the attitude of perioperative nurses towards electronic health records, the use of electronic health records in patient care, and the benefits and challenges of electronic health records in perioperative nursing practice. The chapter covers the following subheadings:
2.1 Conceptual Framework
2.2 Theoretical Framework
2.3 Empirical Review
2.4 Summary of Literature Review

CHAPTER THREE
METHODOLOGY (Preview)
Research Design: The study adopted a descriptive research design.
Population of the Study: The population of the study comprises perioperative nurses working at the University of Benin Teaching Hospital.
Sample Size Determination: The study adopted the Taro Yamane formula to determine a sample size of 54 participants.
Sampling Technique: The study employed a multi-stage sampling technique involving stratified and convenience sampling methods to select the individual respondents.
Research Instrument: The study utilized a structured questionnaire as the instrument for data collection.
Methods of Data Analysis: The collected data were analyzed using frequencies and percentages to summarize and present the demographic characteristics of the respondents and their responses.

CHAPTER FOUR; DATA PRESENTATION AND ANALYSIS
MAJOR FINDINGS (Preview)
The analysis results were presented in tables. Based on the results obtained from the analysis, the following findings are made:

i. The study found that perioperative nurses generally had a positive perception towards the use of Electronic Health Records (EHRs) for patient care in University of Benin Teaching Hospital, as evidenced by their agreement that EHRs improve documentation accuracy, enhance communication among healthcare professionals, and promote better organization and retrieval of patient records. Most respondents disagreed that EHRs make patient care more difficult, increase documentation errors, or are unnecessary for effective perioperative care.

ii. The study found that perioperative nurses demonstrated a generally positive attitude towards the adoption and utilization of Electronic Health Records for patient care in University of Benin Teaching Hospital, as evidenced by their willingness to use EHRs regularly, encouragement of colleagues to adopt the system, and confidence in using it to support quality patient care. Most respondents also disagreed that they preferred traditional paper records, felt reluctant to adopt EHRs, or experienced unnecessary stress from their use.

iii. The study found that perioperative nurses generally perceived Electronic Health Records as beneficial in improving patient care in University of Benin Teaching Hospital, as evidenced by their agreement that EHRs enhance timely access to clinical information, facilitate faster retrieval of patient information, and reduce duplication of patient records. Most respondents disagreed that EHRs provide little benefit to patient safety, fail to improve coordination of care, or increase delays in accessing important patient information.

iv. The study found that adequate training, management support, technical assistance, reliable technological infrastructure, and ease of use were important factors influencing perioperative nurses’ attitudes towards the use of Electronic Health Records in University of Benin Teaching Hospital. This was evidenced by respondents’ agreement that training, technical assistance, and ease of use encourage effective adoption and utilization of EHRs, while their disagreement with statements suggesting that management support, internet connectivity, technical issues, and learning time have no influence indicated that these factors affect their attitudes.

CHAPTER FIVE: DISCUSSION OF FINDINGS
This chapter covers the following outline:
5.1 Discussion of Findings    
5.2 Implications of the Findings
5.3 Limitations of the Study
5.4 Summary
5.5 Conclusion
5.6 Recommendations
5.7 Suggestions for Further Studies

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