Campus Location
Dallas Campus (Online)
Date of Award
8-2025
ORCID
https://orcid.org/009-0005-66173-1063
Document Type
DNP Project
Department
Nursing
Degree Name
Doctor of Nursing Practice
Committee Chair or Primary Advisor
Kris Skalsky
Second Committee Member or Secondary Advisor
Lawrence Santiago
Abstract
Electronic health record (EHR) downtime presents significant challenges to patient safety and care quality in acute care settings, particularly regarding timely medication administration. This project addressed the problem of late or absent medication doses during planned or unplanned EHR downtime. The investigator aimed to evaluate the effectiveness of a structured downtime plan in improving nurses’ ability to administer medications on time during periods of EHR unavailability. The investigator used a quantitative design to implement a downtime plan evaluation paradigm. Data were collected using retrospective chart reviews of medication administration records pre-implementation and postimplementation of the downtime plan. The sample included over 1,000 scheduled medication doses from adult inpatient medical–surgical, progressive care, and intensive care units at a large urban hospital in Texas. The intervention procedures involved implementing an evidence-based downtime plan, including staff downtime practice and standardized documentation tools. Medication administration timeliness was assessed by calculating the number of medications given late or absent before and after the intervention. Chi-square analysis was used to evaluate differences between pre- and postintervention periods. Results showed no statistically significant difference in the rate of timely medication administration between the two periods. Descriptive findings indicated increased staff confidence, improved understanding of downtime procedures, and more consistent documentation practices following implementation. While the intervention did not significantly reduce the number of delayed or omitted doses, the findings suggest that structured preparation and staff training may contribute to better workflow and perceived readiness during EHR downtime. The project highlights the importance of continued evaluation of system processes and supports the development of comprehensive downtime plans that address multiple factors contributing to medication administration delays.
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
Recommended Citation
Baldauf, Grace R., "Electronic Health Record Downtime" (2025). Digital Commons @ ACU, Electronic Theses and Dissertations. Paper 929.
https://digitalcommons.acu.edu/etd/929