Author Affiliations : Texas Tech University Health Sciences Center, Lubbock (Dr Hoelscher); The University of Texas at Tyler (Dr McBride); Texas Nurses Association, Leander (Dr Bumpus); The Gilder Company 13318 Mount Castle Dr. Dallas, Texas 75234 and Texas Tech University Health Sciences Center, Lubbock (Mr Gilder); and Belmont Abbey College 00 Belmont-Mt. Holly Road, Belmont, NC 28012 (Dr Elkind).
Comput Inform Nurs. 2024 Oct 1;42(10):712-721. doi: 10.1097/CIN.0000000000001180.
Nurses faced numerous challenges during the pandemic, particularly with the increased burden of electronic documentation. Surges in patient volume and visits led to rapid changes in nursing documentation, prompting diverse responses from regulatory and healthcare organizations. Nurses expressed safety concerns and struggled with changes, calling for national standards and regulatory support. Policy relaxations, such as the 1135 Waiver, sparked debate on the future of nursing care plan documentation. Using mixed-methods exploratory design, the study identified modifications of nursing documentation during crises, commonalities in documentation burden reduction for applicability beyond pandemics, and consensus on the definition of "surge." Documentation patterns were assessed from February to November 2022, involving 175 North American nurse leaders and informaticists. Data analysis included descriptive statistics, thematic analysis, and Pearson correlation coefficient. Significant differences were found between rural and urban settings ( P = .02), with urban areas showing higher odds of changes to care plans (odds ratio, 4.889; 95% confidence interval, 1.27-18.78). Key findings highlighted the persistence of postcrisis documentation changes and varied definitions of surge criteria based on organizational leadership, policy, and mandates. The study yielded insights for modifying documentation, offering policy recommendations, and emphasizing ongoing collaboration and evidence-based approaches for future nursing practices.
护士在疫情期间面临诸多挑战,尤其是电子文档记录的负担增加。患者数量和就诊量的激增导致护理文档记录迅速变化,促使监管和医疗保健组织做出多样化的反应。护士对安全问题表示担忧,并对变化感到困扰,呼吁制定国家标准和监管支持。政策放宽,如 1135 豁免,引发了关于护理护理计划文档未来的辩论。本研究采用混合方法探索性设计,确定了危机期间护理文档的修改情况、超越大流行适用范围的文档负担减轻的共同性,以及对“激增”定义的共识。从 2022 年 2 月到 11 月,对 175 名北美护士领导人和信息学家进行了评估。数据分析包括描述性统计、主题分析和 Pearson 相关系数。在农村和城市环境之间发现了显著差异(P =.02),城市地区更有可能改变护理计划(优势比,4.889;95%置信区间,1.27-18.78)。主要发现强调了后危机文档更改的持续存在,以及基于组织领导力、政策和任务的激增标准的不同定义。该研究为修改文档提供了见解,提出了政策建议,并强调了未来护理实践中持续合作和循证方法的重要性。