The impact of an electronic nursing documentation system on efficiency of documentation by caregivers in a residential aged care facility.

AIMS AND OBJECTIVES To examine the effect of the introduction of an electronic nursing documentation system on the efficiency of documentation in a residential aged care facility. BACKGROUND Modern technology has the potential to free caregivers in residential aged care facilities from their burden of paper documentation and allow them more time to care for residents. To date, there is inadequate evidence to verify this assumption. DESIGN Longitudinal cohort study with work sampling method for data collection. METHODS This study was conducted between 2009-2011; two months before and 3, 6, 12 and 23 months after implementation of an electronic documentation system. A work classification tool was used by an observer to record documentation activities being performed on paper or on a computer by the caregivers. RESULTS When compared with the proportion of time caregivers spent on documentation in the preimplementation period, personal carers' proportion reduced at three months after implementation. The proportion increased from six months and then dropped at 23 months. Recreational activity officers' proportion increased at three months after implementation. It stabilised at six months and increased again at 12 months. At 23 months, the proportion returned to the preimplementation level. Less than half of the caregivers' time on documentation after implementation was associated with computer-related tasks. CONCLUSIONS Introduction of an electronic documentation system may not necessarily lead to efficiency in documentation for the caregivers. Charting some information items on paper and others on a computer may hinder realization of documentation efficiency. RELEVANCE TO CLINICAL PRACTICE To optimise the efficiency benefit of electronic documentation in a residential aged care facility, it is not only necessary to automate all nursing forms but also to ensure that the system is aligned with caregivers' documentation practice. Continuous education and mentor support is essential to ensure caregivers' effective usage of the electronic system.