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Evaluation of documentation before and after implementation of a nursing information system in an acute care hospital

Authors

Larrabee JH, Boldreghini S, Elder-Sorrells K, Turner ZM, Wender RG, Hart JM, Lenzi PS

Journal

Comput Nurs

Publication Date

2001 Mar-Apr

Volume

Issue

Pages

56-65; quiz 66-8

HIT Description: Electronic health record and nursing documentation. More info...
Purpose of Study: Evaluate nursing information systems (NIS).
Years of study: 1995-1997
Study Design: Time series
Outcomes: Impact on health care effectivness/quality

Summary:

Settings: The study was conducted at a 100-bed urban university hospital in west Tennessee.
Intervention: Nursing information systems (NIS) with order entry, documentation, assessment, and a care plan.
Evaluation Method: Measures of documentation completeness of nurse assessments of patient outcomes (NASSESS), achievement of patient outcomes (NGOAL), and nursing interventions done (NQUAL).
Changes in efficiency and productivity: NIS implementation did not improve documentation within the first six months, but retrained and continued NIS use did significantly improve NASSESS, NGOAL, NQUAL, and blood pressure documentation 18 months postimplementation.

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