Table 4 Translation between studies: Possible benefits through the IT

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]

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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