Skip to main content

Table 4 Translation between studies: Possible benefits through the IT

From: Staff experiences within the implementation of computer-based nursing records in residential aged care facilities: a systematic review and synthesis of qualitative research

  Different information processing Quality of documentation and resident care needs Additional or lost time
Alexander et al. [38] Administrators were optimistic that this technology could improve management oversight and quality management Administrators were optimistic that this technology could improve documentation of resident care Administrator:
nursing homes that implement [technology] need to be warned about the increased need for manpower during the initial months.
Frustration set in when expectations were not met. This increased staff suspicion and decreased desire to work with the system. Frustration set in when expectations were not met, problems not solved in a timely manner
Licensed nurses liked being able to view many things about resident care at once
liked being able to know what was done for their residents in real time identified increased documentation in comparison to the paper record
When the documentation system wasn’t working properly, staff stated they didn’t chart. Others indicated that backup systems for documentation were created. Concerns surfaced about increased potential for errors resulting from service duplication.
Cherry et al. [39] The user group suggested that supervisors were able to more easily monitor documentation of resident care activities, regulatory compliance issues, or staff education needs They agreed that improvements in the quality and accuracy of documentation would be realized. They agreed that improvements in the efficiency would be realized.
Staff would spent less time in documentation tasks
The user group suggested that supervisors were able to more (…) quickly identify resident care needs and address quality of care issues (…)
Specific aspects of care discussed included easier access to charts and medical information
Staff would spend more time in resident care
Better quality of care
Ability to provide automatic alerts (plausibility check)
Cherry et al. [40] Administrators: Administrators: DONs & Charge Nurses:
Staff were able to provide better information because of immediate access Better care to residents because of immediate access to computerized records Nurse supervisors generally believed that the system allowed direct care staff to spent more time with residents and less time in documentation
Immediate access to medical records allowed staff to access resident records without wasting time Improved consistency, accuracy, and quality of documentation Gave the nurses more time on the floor since the paperwork went faster
Fewer holes in documentation from a caregiver’s standpoint
Direct Care Nurses: DONs and Charge Nurses: Direct Care Staff
Nurses’ notes and notes by other caregivers are much easier to read More consistent and legible documentation About half the nurses reported that they had more time to spend with residents because of less time charting, and because of less time looking for “missing” charts, and about half reported no change or an increase in time required for charting and that they had less time with residents because of the amount of time spent in documentation activities
Reports regarding the time required to admit a new resident was mixed, with some nurses reporting that new admissions were much easier and quicker and others reporting that it took much longer.
Important issue discussed was the need for more information about the residents they care for More thorough assessments with assessment templates that guide nurses through body systems for documentation and to help nurses improve observations skills
Ease of access to patient information was a definite benefit identified by the nursing staff Direct Care Nurse:
Several noted how information on residents, including diagnosis and demographics, is now more readily available Half reported Care Plans were easier to originate and maintain, half reported that it was more difficult
Missing charts didn’t matter because the information was in the computer Improved documentation were definite benefits identified by the nursing staff
Information is more readily accessible Quality of care was neutral (no change) to improve after the implementation
DON and Charge Nurse: Guided templates improve observation skills, which in turn provides for better care for the residents
Ability to track and trend quality indicators We are able to more proactive address residents’ problems
Increased ability to monitor staff and complete chart audits in very timely manner Additional information increases a nurses’ awareness of the patient condition and allows for better care
Immediate access to records for any authorized staff member More legible and accurate information
Munyisia et al. [26] The PCs were happy with the electronic documentation system because the access to the residents’ notes had been improved. The paper-based record helped them make real-time care decisions I get a resident’s note on a computer at a finger click. Unlike using the manual system that required me to go over there (points a filing cabinet), search for a folder, come back, find the right page, and when the page was missing, go and get a photocopy. Therefore, access to one resident’s notes would probably take me 20 minutes before I sit down and start writing
I get a resident’s note on a computer at a finger click.
When there was a clinic here (at the facility), the doctor wrote everything on the computer. Therefore I did not have to write progress notes because the doctor has already done it
The only real problem I have is with the continence charts, it takes so long to enter everyone’s information in the system. It can take up to one hour to enter data and when using the paper system, it is just a 5 Min. job
It does get slow to enter data into the computer that you eventually give up
Rantz et al. [41] Communication about resident care was reported as improved Improvement with documentation was noted All expressed concern that there was limited time to spent with residents and that the required documentation and time spent in managing the technology limited the amount of time actually spent with residents
Easier access of information improved communication Licensed and certified staff believed that the care was safer through the use of the system.
All stakeholders concluded that information was more easily accessible Some licensed staff commented that the assessments caused them to think about what to assess and that it helped them identify problems that they might not have otherwise found.
The system required time to operate and manage.
Documentation is too time consuming and a burden
Documentation is perceived as too time consuming
Frustration set in when the system don’t work (that causes more time)
Yu et al. [35] --- --- ---
Zhang et al. [42] The most common viewed benefits for individual staff members are (…) more information to better understand the residents Better understand the residents due to more information The most common viewed benefits for individual staff members are (…) time efficiency
More information to better understand the residents and the care services, to support peer learning and to facilitate performance appraisal for managers Broader and more holistic view of the residents Most of the staff saw reduction of paper work and time saving
Easily check what care had been delivered For instance if I am unsure of how to do the palliative care, I can just easily click a button and find out it has been done for a similar patient at another facility I think the computer is quicker because you can get to delete stuff and you can fix it
Able to see if something has been identified, has somebody done something about It, if there is a gap and ensure that is corrected. It does improve what you want to do because you get the whole picture, not just what’s happened on your shift. It does impact on how I deal with a resident Care plans on paper are very time consuming, and the computer make it faster, since when it’s written once, you don’t need to write it again
It helps me identify what is needed by the staff Improvement in the quality of residents’ records led to improvement in the quality of care Care plans on paper are very time consuming, and the computer make it faster, since when it’s written once, you don’t need to write it again
Opportunities to, like I said, all the information that we need or help out with the students today. Like they wanted to know a little bit about all the resident’s conditions and stuff, so I just set them up on my system and they sat on there for a couple of hours and they really enjoyed it. Say a thing, they were able to find out everything they wanted to know about all the residents as well. Quick response to resident’s care needs It’s easier for the care staff members to entry data even if they are only typing with two fingers
Quicker and easier care decisions, the system has an impact on clinical judgment and decision making
Better care follow up
The most common viewed benefits for individual staff members are ease of access
Some reported it was easier and quicker
Some noted quick data distribution
I just need to enter it into the computer and then that information is there for the staff to see. So it saves a log of time.
Quick data retrieval was a well-recognized benefit. They found it was quicker and easier to find data
  Being able to scroll through and the way the notes are broken up into different categories where you can select whatever it is you are looking for and be done fairly quickly   
  1. Italicized quotations represent the views of participants of included studies. Non-italicized quotations represent views of authors of included studies.
  2. CNA = Certified Nurse Assistant.
  3. DON = Director of Nursing.
  4. PC = Personal Carer.