Technological and Behavioral Determinants of Nurses’ Intention to Use Electronic Health Record Systems in Resource-Constrained Clinical Settings

Electronic health record systems are central to nursing documentation and care coordination, yet uptake by frontline nurses in resource-constrained settings remains uneven, limiting continuity, safety, and data quality. This study examined technological and behavioral determinants of nurses’ intention to use electronic health record systems and whether these relationships vary by education, clinical experience, technology experience, and age. A cross-sectional survey was conducted with registered nurses providing direct patient care in public health facilities. A self-administered questionnaire based on a technology-acceptance framework captured perceptions of usefulness and ease of use, attitudes toward use, personal innovativeness, computer anxiety, and resistance to change. Data from 193 respondents were analyzed using hierarchical multiple regression. Favorable attitudes and higher perceived ease of use were the strongest positive predictors of intention, while computer anxiety showed a negative association. Personal innovativeness was positively associated with both perceived ease of use and intention. The final model explained more than one-third of the variance in intention to use, with only modest additional effects from demographic and experiential moderators. Findings highlight the need to pair usability-focused design with digital-literacy support and change-management strategies tailored to nurses’ prior technology exposure, professional tenure, education, and age.