Post-Implementation Study of a Nursing e-Chart: How Nurses Use Their Time

Nursing documentation is a significant component of electronic health records nevertheless integrating a new chart into nursing activities required multiples strategies to ensure adherence. Current literature demonstrates that nurses spend part of their time performing activities no related with patients' direct care and sometimes even does not fall under their purview. Thus it is important to quantify the effect that a new system could have in the proportion of time dedicated to documentation. The objective of this work was to determine the time dedicated to different activities including those related to electronic documentation after the implementation of a renewed nurse chart in an Electronic Health Record at Hospital Italiano de Buenos Aires. An observational, cross sectional and work sampling study was performed. During the study 2396 observations were made in 3 wards. Nurses' activities included 36.09% of direct care, 28.9% of indirect care, 0.67% support tasks, 22.99% non related to patient tasks, 11.32% personal activities and documenting on EHR 17.43%. The comparison with the previous study shows indirect care activities decreased 12.28% and non-related to patients increased 11.85%. The results demonstrate that the new nurses' e-chart did not increase documentation time.