This study investigates factors influencing nurses' actual use of electronic health record (EHR) systems in resource-limited settings in Botswana, with a focus on addressing barriers to EHR adoption and utilization. Despite the potential benefits of EHR systems, many nurses continue to rely on paper-based records, hampering health care delivery in underserved areas. Using a cross-sectional survey of 193 nurses from 55 health care facilities, this research identifies key predictors of EHR use. The modified Unified Theory of Acceptance and Use of Technology (UTAUT) model developed in this study highlights behavioral intention, facilitating conditions, and EHR experience as significant factors influencing EHR utilization. Effort expectancy and computer self-efficacy were found to be less impactful. The results suggest that targeted interventions focusing on improving behavioral intention, enhancing infrastructure, and increasing nurses' EHR experience can significantly boost EHR adoption. These findings offer actionable recommendations for health care organizations aiming to improve EHR implementation, ultimately leading to better patient outcomes in resource-limited environments.