Background and Objectives: This study at a national tertiary hospital in Manila, Philippines investigated the use of the "Copy and Paste" Function (CPF) within their Electronic Medical Record (EMR). While CPF has benefits and risks, little is known about its usage patterns and impact on patient safety at the institution. This study explores nurses' perceptions and recommendations on CPF use in this hospital’s EMR, assessing its prevalence, impact on patient safety, associations between prevalence and impact, and providing usage recommendations. Methods: A sequential explanatory research design was employed using surveys and semi-structured interviews. Ethical clearance was obtained before data collection. Instruments were adapted from similar studies and have undergone expert validation. Content validity was confirmed, and internal consistency was acceptable (Cronbach’s Alpha = 0.77). Stratified random sampling determined the respondents per area. Data analysis included descriptive statistics, Spearman’s rho, and thematic analysis. Results: The survey (n = 256) showed CPF use by nurses and doctors, and was confirmed by semi-structured interviews (n = 9). Nurses generally perceived CPF's impact on documentation as neutral (40.17%), leaning towards positive impact. Interviews supported this, revealing both “challenges” and “benefits” of CPF use as themes after thematic analysis. There was no statistically significant association between perceived CPF prevalence and its perceived impact on patient safety (p = 0.164). The theme “considerations for safe CPF use” also emerged from the analysis. Conclusion This study found mixed perceptions on CPF’s impact in healthcare. There is a call to continue its use, but safety measures must be implemented first. Recommendations include order verification, caution, practice standardization, selective CPF usage, additional technological features, and alternative documentation methods. A governance structure to manage EMR-related issues, such as unsafe CPF practices, is also recommended to ensure proper monitoring and response.
patient safety ; nurses ; Philippines

BACKGROUND

Nurses are at the forefront of caring for patients during the height of the COVID-19 pandemic. Nurses themselves are exposed to serious risk and even death while providing care for these patients. Among other healthcare professionals, nurses are mostly exposed to psychologically distressing situations during this time of crisis. Fear of COVID-19 can affect nurses’ overall well-being, which in turn may affect their job performance and lead to a decline in the quality of patient care.

OBJECTIVES

To determine the level of fear of COVID-19, and to explore the experiences of COVID-19-related fear of frontline nurses in a national university hospital in the Philippines.

METHODS

To achieve the study objectives, the study utilized a convergent mixed methodology approach. In the quantitative phase, a random sample of participants completed the Fear of COVID-19 scale (FCV-19S) in order to assess their level of fear of COVID-19. Semistructured interviews were conducted in the qualitative strand. Participants in the qualitative phase was selected using maximum variation sampling. Integration of data was done through a narrative contiguous approach.

RESULTS

Quantitative data was obtained from 206 frontline registered nurses. The mean age of the participants was 35.5 years (SD =8.17). Overall, the composite score of the fear of COVID-19 scale was 21.76 (SD = 4.92), indicating an elevated level of fear. Having friends and relatives who tested positive predicted fear of COVID-19 (β = -3.658; p = 0.005; CI: -6.213 to -1.104). Three major themes categories emerged from qualitative data analysis: (1) balancing feelings of fear and moral obligation, (2) challenges experienced while providing frontline work, and (3) resilience amidst challenges. For the reporting and integration of our mixed-method results, a narrative contiguous approach was implemented.

CONCLUSIONS

Frontline nurses reported an elevated level of fear during the height of the COVID-19 pandemic. This study was also able to capture the impact of COVID-19 on the mental health of nurses, specifically on their fear experiences. Understanding the underlying causes of fear, such as uncertainties surrounding guidelines and protocols, shortage of personal protective equipment, and moral distress, offers invaluable insights for shaping proactive strategies and policies aimed at mitigating these concerns in subsequent pandemics.

Human ; Covid-19 ; Fear ; Nurses