title: Participants' perceptions of an intervention implemented in an Action Research Nursing Documentation Project.
abstract: OBJECTIVE
  The aim of this study is to describe healthcare professionals' experiences and perceptions of an intervention implemented in an action research project conducted to improve nursing documentation practices in four municipalities in Norway.
  
  
  BACKGROUND
  Documentation of individualized patient care is a continuing concern in healthcare services and could impacts the quality and safety of healthcare. Use of electronic systems has made some aspects of documentation more comprehensive, but creation of an individualized care plan remains a pressing issue.
  
  
  METHODS
  A qualitative descriptive design was used.
  
  
  METHODS
  An action research project was conducted between 2010-2012 to improve the content and quality of nursing documentation in community healthcare services in four municipalities. One year after the project was completed four focus group interviews were conducted with healthcare professionals, one for each involved municipality. Two unit managers were interviewed individually. Qualitative content analysis was used.
  
  
  RESULTS
  Three themes emerged: healthcare professionals perceived competing interest; they experienced that they had to manage complexity and changes; and they highlighted a clear and visible leader as important for success.
  
  
  CONCLUSIONS
  Quality improvement activities are essential. Healthcare professionals experience a complicated situation when electronic health record systems do not support workflow. Further research is recommended to focus on the functionality and user interface of electronic health record systems, and on the role of leadership when implementing changes in clinical practice.
  
  
  CONCLUSIONS
  Stronger cooperation among policymakers, electronic health record system vendors, and healthcare professionals is essential for improving electronic health record systems and documentation practices. Involvement of end-users in these improvements can make a difference in the way the systems are perceived in the clinical workflow.
authors.affiliation: Department of Health and Nursing Science, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway.
authors.forename: Grete
authors.initials: G
authors.lastname: Vabo
authors.affiliation: Department of Health and Nursing Science, Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway.
authors.forename: Åshild
authors.initials: Å
authors.lastname: Slettebø
authors.affiliation: Department of Health and Nursing Science, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway.|Faculty of Health, School of Nursing and Midwifery, Deakin University, Melbourne, Vic., Australia.
authors.forename: Mariann
authors.initials: M
authors.lastname: Fossum
mesh_terms: D004282:Documentation / Q000379:methods*; D006302:Health Services Research; D006801:Humans; D007857:Leadership; D009664:Norway; D009737:Nursing Records; D010347:Patient Care Planning / Q000458:organization & administration*; D036301:Qualitative Research; D012107:Research Design; D057188:Workflow
keywords: action research; implementation evidence based practice; nursing documentation; nursing organization; usability issues