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J Nurs Adm. 2017 Dec;47(12):610-615. doi: 10.1097/NNA.0000000000000555.

The Impact of an Electronic Medication Administration Record (eMAR) and Computerized Physician Order Entry (CPOE) on Nurse Extender and Unit Clerk Staffing.

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Author Affiliations: Chief Transformation Officer (Dr Robinson), Value Institute, Christiana Care Health System, Wilmington, DE; Assistant Professor (Dr Bergey), Department of Sociology, Villanova University, PA; Program Manager (Ms Brady), IT Informatics, and Clinical Data Researcher (Ms Mapp), Value Institute, Christiana Care Health System, Newark, DE; Senior Project Manager (Ms Goldsack), Duke Clinical Research Institute, Duke University, Durham, NC.



The aim of this study is to describe the impact of the introduction of health information technology (HIT) on the utilization and payroll costs of nurse extenders and unit clerks in medicine and surgery units in a large regional health system.


Long-term policy goals of HIT implementation are reported to include system-level reductions in labor costs, achieved through improved efficiency.


Using a retrospective cohort model, we analyzed how hours worked per patient day and staffing costs per patient day varied with the implementation of HIT over time at 2 different hospitals within a health system.


Implementation of electronic medication administration records was not associated with significant changes in staffing or labor costs. Both labor hours and costs associated with nurse extenders and unit clerks were significantly reduced after the subsequent addition of computerized provider order entry. Simultaneously, units that did not implement any HIT experienced a significant increase in both labor hours and costs.


Health information technology implementation in the inpatient setting is associated with significant savings in labor hours and costs in non-registered nursing roles.

[Indexed for MEDLINE]

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