Teaching for safe practice: Why EHR competency is no longer optional in Nursing Education
Patient safety has long been a foundational responsibility of nursing education. In 2026, the Joint Commission made that responsibility unmistakably clear with a revision of the National Performance Goals (NPGs) — 14 high-priority, measurable goals that elevate select accreditation requirements beyond minimum compliance and intensify the focus on safety, quality, and outcomes across healthcare organizations. These National Performance Goals depend directly on EHR-based documentation and communication workflows.
National performance goals that depend on EHR competency
- NPG #1 – Right patient, right care
Accurate patient identification, order verification, and handoff communication are executed within the EHR. - NPG #5 – Preventing and controlling infection
Isolation status, laboratory results, and infection risk communication rely on timely, visible EHR documentation. - NPG #6 – Pain and pain management
Pain assessment, medication administration, nonpharmacologic interventions, and reassessment are documented through structured EHR workflows. - NPG #14 – Effectively managing medications
Medication reconciliation, barcode scanning, allergy verification, and MAR documentation are EHR-dependent safety processes.
For today’s nurse, achieving these goals is inseparable from effective use of the electronic health record (EHR). Nurses authenticate patient identity, reconcile medications, verify orders, document assessments, and communicate critical findings almost entirely within digital systems. Time and motion studies consistently show that nurses spend approximately one-quarter to one-third of every shift interacting with the EHR, with documentation accounting for the largest share of that time.
Research demonstrates that insufficient EHR preparation contributes to increased cognitive load, documentation errors, stress during transition to practice, and early-career burnout among new nurses.
At a time when healthcare organizations face heightened scrutiny related to patient safety outcomes, workforce shortages, and documentation-driven accountability, nursing education represents the first line of prevention for documentation-related risk. The National Performance Goals compel nursing programs to reconsider where EHR competency resides in the curriculum — not as an instructional enhancement, but as a patient safety obligation aligned with national accreditation expectations.
The regulatory imperative: Safety is measured in the EHR
The National Performance Goals operationalize patient safety through electronic documentation and communication workflows. Patient safety, as defined by the Joint Commission, is no longer conceptual — it is demonstrated through performance captured in the EHR.
Key goals — including Right Patient, Right Care; Preventing and Controlling Infection; Pain and Pain Management; and Effectively Managing Medications — depend directly on accurate, timely electronic documentation. These goals validate what clinical practice already makes clear: safe nursing care cannot be separated from documentation competency.
The workforce impact: Burnout and transition-to-practice risk
EHR burden is not solely an individual challenge; it is a system-level workforce issue. According to the Future Ready Healthcare Survey Report (2025), 62% of healthcare leaders identify EHR management as a critical workflow challenge, placing documentation burden alongside staffing shortages and administrative complexity.
Wolters Kluwer Expert Insights further demonstrate how documentation inefficiency contributes directly to burnout. In How to improve the nurse experience with a simplified EHR, poorly optimized workflows and insufficient preparation are shown to reduce time for patient care and increase stress — particularly during early stages of practice.
Deferring EHR competency until employment shifts avoidable documentation risk to novice nurses during the most vulnerable phase of practice.
Academic EHR infrastructure as the educational solution
Purpose-built academic EHR platforms allow students to develop baseline fluency in documentation, communication, and clinical judgment before entering high-stakes clinical environments.
Evidence suggests this preparation carries forward into professional practice. As outlined in How an educational EHR improves patient outcomes on the job, nurses trained in academic EHR environments demonstrate stronger documentation confidence, faster adaptation to workplace systems, and the ability to contribute to patient safety earlier in their careers.
Effective preparation also requires access to evidence-based decision support within documentation workflows. As described in Operationalize evidence-based nursing care across settings, integrating clinical decision support within EHR workflows helps nurses apply current evidence consistently, reduce variation in practice, and make safer decisions at the point of care.
Enabling safe, regulated practice
The National Performance Goals define a measurable vision for safe healthcare delivery — one in which accurate documentation, reliable communication, and informed decision-making are essential to protecting patients from harm. Because these outcomes are operationalized through the EHR, nursing education must respond accordingly.
Comprehensive EHR training is no longer elective. It is foundational infrastructure for preparing nurses who can document safely, think critically, and contribute meaningfully to patient care from their first day in practice.
Lippincott® DocuCare provides a realistic, practice-safe academic EHR environment that enables students to practice documentation within structured, case-based workflows. When paired with Wolters Kluwer’s trusted clinical decision-support tool, Lippincott® Advisor, students learn not only how to document, but why documentation matters — within the context of evidence-based care and regulatory accountability.
To explore how academic EHRs and integrated decision support can strengthen patient safety, accreditation alignment, and workforce readiness, request a Lippincott® DocuCare demonstration.
