The association between perceived electronic health record usability and professional burnout among US nurses

Edward R. Melnick, Colin P. West, Bidisha Nath, Pamela F. Cipriano, Cheryl Peterson, Daniel V. Satele, Tait Shanafelt, Liselotte N. Dyrbye

Research output: Contribution to journalArticlepeer-review


Objectives: To measure nurse-perceived electronic health records (EHR) usability with a standardized metric of technology usability and evaluate its association with professional burnout. Methods: A cross-sectional survey of a random sample of US nurses was conducted in November 2017. EHR usability was measured with the System Usability Scale (SUS; range 0-100) and burnout with the Maslach Burnout Inventory. Results: Among the 86 858 nurses who were invited, 8638 (9.9%) completed the survey. The mean nurse-rated EHR SUS score was 57.6 (SD 16.3). A score of 57.6 is in the bottom 24% of scores across previous studies and categorized with a grade of "F."On multivariable analysis adjusting for age, gender, race, ethnicity, relationship status, children, highest nursing-related degree, mean hours worked per week, years of nursing experience, advanced certification, and practice setting, nurse-rated EHR usability was associated with burnout with each 1 point more favorable SUS score and associated with a 2% lower odds of burnout (OR 0.98; 95% CI, 0.97-0.99; P <. 001). Conclusions: Nurses rated the usability of their current EHR in the low marginal range of acceptability using a standardized metric of technology usability. EHR usability and the odds of burnout were strongly associated with a dose-response relationship.

Original languageEnglish (US)
Pages (from-to)1632-1641
Number of pages10
JournalJournal of the American Medical Informatics Association
Issue number8
StatePublished - Aug 2021


  • burnout
  • electronic health record
  • nursing care
  • professional
  • usability

ASJC Scopus subject areas

  • Health Informatics


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