Does the implementation of a clinical information system decrease the time intensive care nurses spend on documentation of care?
BACKGROUND
The number of intensive care units (ICU) using a clinical information system (CIS) is increasing. It is believed that replacing manual charting with an automatic documentation system allocates nurses more time for patient care. The objective of this study was to measure changes in nurses' working time utilization after the implementation of a CIS in a polyvalent ICU of a large Finnish central hospital.


METHODS
An activity analysis-based comparison of the ICU nurses' working time utilization before and after the implementation of a CIS.


RESULTS
After the implementation of a CIS the total time the nurses spent on documentation of nursing care increased by 3.6% (NS), 15 min per shift of 8 h per nurse. The total time they spent on patient care increased by 5.5% (P < 0.05), 21 min. Intensive care nursing activities increased by 3.7% (P < 0.05), 14 min. The length of the nurses' ICU experience had some effect on these figures. The demand for nurse labor remained constant.


CONCLUSIONS
After the implementation of a CIS, an increase in the time nurses spent on documentation of care was detected, which suggests a need for further development of the system. As all the measured time changes were relatively small, any plans to reduce the ICU staff number with the aid of computers were not justified.
Saarinen
K
K
Department of Intensive Care Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland. kari.saarinen@epshp.fi
Aho
M
M
D002984:Clinical Laboratory Information Systems; D003422:Critical Care; D004282:Documentation; D005500:Follow-Up Studies; D007362:Intensive Care Units / Q000458:organization & administration*; D009726:Nurses; D013996:Time and Motion Studies; D000078329:Workforce