The impact of a clinical information system in an intensive care unit.
OBJECTIVE
Although clinical information systems (CISs) have been available and implemented in many Intensive care Units (ICUs) for more than a decade, there is little objective evidence of their impact on the quality of care and staff perceptions. This study was performed to compare time spent charting with pen and paper patient data versus time spent with the new electronic CIS and to evaluate staff perceptions of a CIS in an ICU.


METHODS
Time spent every day was calculated for each patient, for 7 days, for recording on the paper vital signs and physician therapeutic orders and time spent for computing fluid balance and scores. This time was then compared with time required to make the same activities by means of CIS, 10 months after its introduction in ICU. Four years after the installation of CIS, a questionnaire was given to all staff attending to the ICU to evaluate their opinions of the CIS.


RESULTS
The CIS took less staff time to record common ICU data than paper records (3 +/- 2 minutes/day versus 37 +/- 7 minutes/day respectively, P< 0.001). Perceptions of the CIS were that computers promoted an improving charting quality.


CONCLUSIONS
The implementation of a CIS was associated with a reduced time spent for daily activity and a positive medical and nursing staff perception.
Donati
Abele
A
Intensive Care Unit, University Hospital, Ospedali Riuniti Umberto I - G.M. Lancisi - G. Salesi,Torrette, Ancona, Italy.
Gabbanelli
Vincenzo
V
Pantanetti
Simona
S
Carletti
Paola
P
Principi
Tiziana
T
Marini
Benedetto
B
Nataloni
Simonetta
S
Sambo
Gisella
G
Pelaia
Paolo
P
D018806:APACHE; D003625:Data Collection; D006751:Hospital Information Systems / Q000592:standards*; D006801:Humans; D007362:Intensive Care Units / Q000592:standards*; D016347:Medical Records Systems, Computerized; D008505:Medical Staff, Hospital; D008991:Monitoring, Physiologic / Q000379:methods; D017063:Outcome Assessment, Health Care / Q000379:methods*; D011795:Surveys and Questionnaires; D013997:Time Factors