A new dimension in documentation: the PIE method.

In February 1986, the 43-bed neurology/neurosurgery unit at a midwestern medical center implemented the problem identification, intervention, and evaluation (PIE) method of documentation. This method incorporates the plan of care into the nursing progress notes, eliminating the need for a traditional care plan. Identified patient problems are documented on a problem list in the form of nursing diagnoses. These problems are evaluated each shift in the nursing progress notes. Routine interventions and assessments are documented on a comprehensive flow sheet. Since the inception of the PIE method, the quality of documentation on the unit has increased, while time spent on charting has decreased. Professional accountability and credibility are evident as nurses document nursing interventions and evaluate their effectiveness.