Identifying and addressing ethical issues with use of electronic health records

Susan McBride, Mari Tietze, Catherine Robichaux, Liz Stokes, Eileen Weber

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


With the passage of the Health Information Technology for Economic and Clinical Health Act in 2009, the United States, as of 2017, has achieved 95% saturation with electronic health records as a means to document healthcare delivery in acute care hospitals and guide clinical decision making. Evidence is mounting that EHRs are resulting in unintended consequences with patient safety implications. Clinical teams confront usability challenges that can present ethical issues requiring ethical decision-making models to support clinicians in appropriate action on behalf of safe, effective clinical care. The purpose of this article is to identify and address ethical issues raised by nurses in use of electronic health records. We provide a case scenario with application of the Four Component Model and describe a study of nurse experiences with the EHR. The nursing Code of Ethics, Nursing Scope and Standards, and Legal Implications are reviewed, and we conclude with recommendations and a call to action.

Original languageEnglish (US)
JournalOnline Journal of Issues in Nursing
Issue number1
StatePublished - Jan 1 2018

Bibliographical note

Publisher Copyright:
© 2017 The American Nurses Association, Inc.


  • Electronic health records
  • Ethical decision making
  • Ethics
  • Health Information Technology
  • Moral distress
  • Patient safety
  • Quality
  • Rest Four Component Model
  • Unintended consequences
  • Usability


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