Paper
Friday, July 23, 2004
This presentation is part of : Health Informatics
A Collaborative Approach to the Implementation of a Bedside Computer Documentation System
Carole Ann McKenzie, CNM, PhD, College of Nursing and Health Sciences, College of Nursing and Health Sciences, The University of Texas At Tyler, Tyler, TX, USA
Learning Objective #1: Discuss the outcomes of implementing a bedside computer documentation system
Learning Objective #2: Elaborate on the collaborative relationship among clinical, administrative, and educational outcomes in implementing a major change, such as a bedside computer documentation system

Objective: Document the knowledge and attitude of nursing staff throughout the implementation of a bedside computer documentation system (BCDS) utilizing a collaborative team of experts from practice, education, and research.

Design: Time-Series. Pre-test with follow-up surveys at 3, 6, 12, and 18-months.

Sample/Setting: Sample consisted of 59 registered nurses who were surveyed one or more times during implementation. Setting was a Level II Birthing Center located in Texas. The study was conducted over a period of 18 months.

Variables Studied: Variables for the study were attitude, time, content; training, support, communication; and accuracy, time, content related to the BCDS.

Methods: Four-part survey collected information related to demographics, and the variables. Parts 1/2 of the survey were administered during each collection period. Part 3 of the survey was added after BCDS initiation and continued through the study. Part 4 of the survey was only administered during the 6-month and successive surveys.

Findings: Satisfaction with type of documentation improved on each survey after implementation. Overtime related to end of shift documentation initially increased from 2 to 2.5 hours at 3-months, then decreased to 1.5 hours. Nurses also indicated that duplication of documentation decreased, comprehensiveness of documentation increased, and communication within and between patient care units increased after implementation of BCDS.

Conclusions: Many anticipated obstacles to the change were not encountered. Computerized documentation systems can result in improved documentation and employee satisfaction while decreasing costs.

Implications: Change can occur within conflict and bedside documentation systems improve attitude, accuracy of documentation and productivity. Collaboration with hospital and college faculty provides the best of both worlds and documents outcomes in a research format that is useful to administrators in decision--making.

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