Written and computerized care plans. Organizational processes and effect on patient outcomes

• HIT Description: A software package run on an IBM compatible computer for documentation of care plans More info...
  
• Purpose of Study: Determine how use of a standardized nomenclature for nursing diagnosis and intervention statements on the computerized nursing care plan in a long-term care facility would affect patient outcomes, as well as organizational processes and outcomes.
  
• Years of study: Not Available
  
• Study Design: RCT
  
• Outcomes: Patient outcomes (e.g., mobility, independence in activities of daily living, cognitive ability), organizational processes (e.g., number of nursing diagnoses and interventions documented per patient), and organizational outcomes (e.g., nursing time to develop and write a care plan)
  

• Settings: A Continuing Care Retirement Center (CCRC), a long-term care (LTC) facility, with a 48-bed health center licensed for skilled and intermediate care.
• Intervention: Two methods of documenting clinical decisions and plans: Group I Ð Computer care plan; Group II Ð Paper care plan. 20 participants were randomly assigned to either Group I or Group II.
• Evaluation Method: Experimental design and repeated measures ANOVA
• Description: A software package run on an IBM compatible computer for documentation of care plans
• Strategy: A computer was in place at the study site and RNs (n = 4) who were computer literate were given an 8-hour training session by the Director of Nursing on the new software package for the care plan and minimum data set assessment.
• Extrinsic Factors in valuing cost and benefits: Care plans for residents in LTC which document the steps of the nursing process are mandated by the U.S. Department of Health and Human Services.
• Cost of Implementation: Eight hours of training of four nurses by the Director of Nursing.
• Clinical Outcomes: There were no significant group differences in terms of patient outcomes. Nurses in the computerized care plan group had significantly more nursing interventions and activities.
• Changes in efficiency and productivity: The computerized care plan took significantly longer to develop, although preparation time decreased over time.�