Electronic versus paper-based documentation : improving efficiency and effectiveness of care

Abstract

Overview of the topic: Electronic Health Records (EHR) are increasing in use with technological advancements. The introduction of EHR aims at improving the efficiency of documentation while improving the quality of care since paper-based records can result in incomplete and illegible reports. Consequently, this dissertation assesses whether EHR improves efficiency amongst nurses. The research question: Is electronic documentation more effective than paper-based documentation amongst nurses in improving efficiency and effectiveness of care? PICO elements: The population (P) studied was nurses. The intervention (I) observed was EHR and the comparison intervention (C) was paper-based documentation. The expected outcome (O) was efficiency and effectiveness of care. Method: The key elements of the PICO and their synonyms were combined using the Boolean Operators. Limiters were applied to narrow the results and these terms were researched in the databases of Hydi, PubMed, MEDLINE (ProQuest), EBSCO Host and Scopus. The PRISMA checklist (2009) helped to exclude irrelevant articles while the inclusion-exclusion criteria assessed the articles’ eligibility (Table 2.8). The Critical Appraisal Skills Programme (CASP) tool was used to critically appraise the literature. Results: The five key studies chosen included two systematic reviews, one cohort study, one qualitative study and one pre-test, post-test intervention study. All studies found significant differences in time and efficiency between EHR and paper-based studies, however, findings were unreliable in other areas of care. Conclusion: Various benefits can be achieved when adopting computerised reports and this switch is inevitable with all the technological advancements. Although EHR bring some disadvantages, they will lead to better nursing care efficiency and will ease the workload and stress that is put on nurses. Implications and recommendations: Increasing computer literacy amongst nurses is essential since EHRs might bring frustration and stress to computer-illiterate nurses. Managers should encourage nurses to educate themselves and support them as this change might not be easy. The pros and cons must be evaluated, and more research should be done using larger sample sizes to better understand the effects of EHR.