Transitioning from paper to computerized documentation.
Although charting forms have evolved over time to meet the changing needs in healthcare, little has changed in the process of documentation until the introduction of computers in healthcare in the late 20th century. The author describes three early nursing documentation systems and the evolution of the automated process. One of the important lessons learned about the move from paper to computerized charting is that the process is not "automatic."
Turpin
Patricia G
PG
D003625:Data Collection / Q000379:methods; D004282:Documentation / Q000379:methods; D005260:Female; D005544:Forecasting; D005762:Gastroenterology; D006801:Humans; D008297:Male; D016347:Medical Records Systems, Computerized / Q000592:standards* / Q000639:trends; D009737:Nursing Records / Q000592:standards*; D012680:Sensitivity and Specificity