Three Method Staff Education: An Innovative Approach to Improve Nursing Care Plan Documentation

Nursing care plans (NCP) help guide daily nursing practice allowing nurses to utilize evidence based practice at the bedside. Reviewing the NCP every shift is important to ensure appropriateness of interventions. For the past 3 years, the compliance rate of reviewing the NCP has been low. In 2011, the policy was reviewed and revised. The change in policy improved compliance from 35% in 2011 to 56% in 2012. To further improve the rate of review, the Clinical Documentation committee partnered with the Nursing Standards of Care Committee to address the issue.  Nurses were surveyed to determine factors for low compliance and lack of education was identified. Almost half of the nurses (47%) said that they could benefit from NCP education. To best meet the educational needs of all nurses, three education methods were created and implemented in April 2013. The 3 education methods included an online module, electronic medical record (EMAR) class training, and focus group discussions. In the online module, nurses had 1 month to complete on their own time. EMAR sessions were scheduled classes that enabled nurses to have hands on computer documentation. Lastly, in the focus groups which were scheduled sessions, scenarios were created for discussion on how to properly document in the EMAR. A post education survey was sent in June 2013. Of the 319 responders, 60.6% completed the online module, 24.8% EPIC training, and 7.7% focus group. Results showed, 67.2% of nurses said their learning was enhanced with the various educational sessions offered and 62% stated the education did not change their NCP documentation practice which was consistent with the 50% compliance rate for reviewing NCP in our July 2013 audit. The results suggest that offering various method of education enhances learning. Further investigation is needed in finding out why the education did not change staff NCP documentation practice.