[Identifying Usability Level and Factors Affecting Electronic Nursing Record Systems: A Multi-institutional Time-motion Approach].

PURPOSE: The usability, user satisfaction, and impact of electronic nursing record (ENR) systems were investigated. METHODS: This mixed-method research was performed as a time-motion (TM) study and a survey which were carried out at six hospitals between August and November 2013. The TM study involved 108 nurses from medical, surgical, and intensive care units at each hospital, plus an additional 48 nurses who served as nonparticipating observers. In the survey, 1879 volunteer nurses completed the Impact of ENR Systems Scale, the System Usability Scale, and a global satisfaction scale. Qualitative and quantitative analyses were performed. RESULTS: The mean scores for the ENR impact, system usability, and satisfaction were 4.28 (out of 6), 58.62 (out of 100), and 74.31 (out of 100), respectively, and they differed significantly between hospitals (F=43.43, p<.001, F=53.08 and p<.001, and F=29.13 and p<.001, respectively). A workflow fragmentation assessment revealed different patterns of ENR system use among the included hospitals. Three user characteristics-educational background, practice period, and experience of using paper records-significantly affected the system usability and satisfaction scores. CONCLUSION: The system quality varied widely among the ENR systems. The generally low-to-moderate levels of system usability and user satisfaction suggest many opportunities for improvement.

Evaluation of the completeness of the nursing process for patients having gastrectomy using electronic nursing records.

The purpose of this study was to evaluate recording completeness of the nursing process. We compared nursing statements documented at the time when the Electronic Nursing Record (ENR) system, based on the ICNP, was implemented in 2004 with those documented in 2007. The ENRs for 35 gastrectomy patients in each year were selected for evaluation. The selected data were 11,822 nursing statements in 2004 and 27,870 in 2007. The results indicated a significant increase in the completeness of the nursing process in 2007. In addition, the number of nursing diagnosis increased by 5.1 times. The most contributing factor for this increase is assumed to be nurse education.

A content analysis of the nursing records pre- and post-implementation of an electronic nursing record system.

After the application of an EMR system in 2004, we could find the meaningful differences in the content of nursing records in a tertiary teaching hospital, Seoul, Korea.

Comparison of direct and indirect nursing-care times between physician order entry system and electronic medical records.

This study compared the amount of time spent by nursing personnel on direct and indirect nursing care between a physician order entry (POE) system and an electronic medical record (EMR) system. Nursing-care time was measured by direct observation or a self-reporting method, both using a stopwatch. Nursing activities were categorized according to modified versions of the tools reported by Park. The implementation of an EMR system increased the direct nursing-care times for all nursing positions. However, the indirect nursing-care times of head nurses and nurse aids was lower, whereas that of registered nurses was higher, and the direct and indirect nursing-care times of RNs varied with the nursing unit and shift. The increases in direct nursing times, especially that spent by nurses providing descriptions and education to patients at their bedside, led to a global improvement in the nursing quality, and the indirect nursing times varied with the nursing position.